Episode 9: Heterotopic ossification (HO)
featured guest Bridget Ripa
Notes by Alexis Lancaster
What is it?
- The formation of bone inside soft tissue structures, where it’s not supposed to be
- It is extra-articular, so it occurs outside of the joint capsule
What is involved? How does it happen?
- Exact pathophysiology is unknown
- Usually comes from a period of immobilization or traumatic injury to that bone or to the affected area of the body
- Swelling, redness, warm to the touch
- Similar to a DVT presentation
- Presents similarly to an infection within that area, such as thrombophlebitis, osteomyelitis, cellulitis, sepsis, septic arthritis
- Can present as a fracture, trauma, bruise, hematoma
- XRay (gold standard)
- Bone scan
- As the PT you can’t change the bone formation once it occurs
- Maintain ROM of the joint/area
- Maintain strength
- Prophylaxis is important: before HO occurs, you want to make sure you are paying attention to maintaining ROM with positioning, splinting/bracing early on to avoid HO development
On the NPTE
- Might be integrated into a question
- “During an initial evaluation of a patient s/p MVA with a complete lesion at C7, the PT notes redness, swelling, and warmth at the posterior knee joint. Which of the following conditions would most likely be present?
- Dependent on answers if HO is an answer, you can go with that
- Could be DVT, as well
- Consider answers that are available on the test!