Heterotopic Ossification (HO); Myositis Ossificans; Rhabdomyolysis

How can rhabdomyolysis be avoided?

thoughtfully plan out your exercise routines, drink adequate amounts of fluid, and minimize your workout time in extreme heat conditions

Myositis ossificans is more commonly associated with what?

young athletic injuries

What are the mechanical aspects of Rhabdomyolysis?

• Crush injury • Burns (including electrical injuries) • Compression • Compartment syndrome

What are the chemical aspects of rhabdomyolysis?

• Medications • Herbal supplements containing ephedra (rare) • Excessive alcohol use • Electrolyte abnormalities • Infections • Endocrine disorders • Heritable muscle enzyme deficiencies • Mushroom poisoning (rare)

What are the clinical manifestations of HO?

• Muscle pain • Loss of ROM (may experienced a hard end-feel early in range) • Swelling • Warmth/erythema • Tenderness to palpation

What is included in the prevention and treatment of HO?

• Pharmaceuticals • NSAIDS used in the first 3 weeks (inhibit undifferentiated cells from developing into osteoblasts) • Diphosphonates (inhibit osteoid cells from calcifying) • Radiation treatments (both prevention and treatment) • Surgical removal (usually delayed until the bone matures and develops a distinct fibrous capsule)

What are the physical aspects of Rhabdomyolysis?

• Prolonged high fever; hyperthermia • Electric current (electrical and lightning injuries) • Excessive physical exertion

Heterotopic Ossification is a ___ condition where abnormal bone formation in soft tissue occurs primarily following trauma, surgical procedures, spinal cord and traumatic brain injuries, burns, and amputations

Benign

Rhabdomyolysis is recently an emphasis of discussion in exercise due to popularity of what?

HIIT

Differs from heterotopic ossification even though they are similar in radiographic and histologic characteristics.

Myositis Ossificans

Rapid breakdown of skeletal muscle tissue; due to mechanical, physical, or chemical traumatic injury

Rhabdomyolysis

HO in individuals with spinal cord injuries is often referred to as what?

a neurogenetic HO; appears to be related to degree of completeness of spinal cord injury more than specific level

Rhabdomyolysis can lead to what?

acute renal failure

Rhabdomyolysis results in a large release of ___ enzymes and other cell by-products into blood stream following muscle breakdown

creatine phosphokinase (CPK)

With rhabdomyolysis, leaking of potassium causing hyperkalemia could potentially cause what?

heart arrhythmias

With rhabdomyolysis, individual may report muscle pain and weakness ranging from ___ to ___

mild to severe

HO develops in non-osseous tissues vs ___ ossificans forms specifically in bruised, damaged, or inflamed muscle tissue

myositis

Myositis ossificans is most commonly seen in ___ and ___

quadriceps and musculature of upper arm

Defined as bone formation in non-osseous tissues (usually muscle and other soft-tissues)

Heterotopic Ossification

How can you treat rhabdomyolysis?

IV fluids/ fluid replacement, urinary alkalization, and blood transfusion