Ossifying myositis: photos, symptoms, effects, treatment. What are the predictions for treatment of patients with ossifying myositis?
Myositis is a disease that occurs for a number of reasons and leads to the appearance of an inflammatory process in the muscle tissues. Depending on what caused the ailment, it is classified into different types. One group of pathological conditions is conditionally safe and treatable, while the other, causing serious disturbances in the body, can lead to death. In the article we will consider the main questions concerning this pathology. Here the reader will know in which cases myositis occurs, what prognoses for treatment with ossifying myositis exist today, how to protect themselves from this disease.
What is it?
To myositis is a whole range of diseases, which are based on the inflammatory process that occurs in the muscles. A key symptom that indicates the possible occurrence of a disease in the body is muscle pain, which is aggravated by movement or probing. Pathology occurs against the background of a transmitted infection or hypothermia, and can also develop due to autoimmune diseases, injuries, bruises and so on.
The causes of the disease are conventionally classified into two groups:
- endogenous - that arise inside the body;
- exogenous - causes from the outside.
To endogenous can be attributed:
- autoimmune diseases, such as lupus erythematosus, rheumatoid arthritis, etc.;
- infections of various nature - enterovirus, typhoid, influenza;
- diseases caused by activity in the human body of parasites( echinococcosis, trichinosis);
- intoxication of the body.
Exogenous causes are considered to be trauma, hypothermia, periodic muscle tension caused by an activity. Myositis is considered an occupational disease of musicians, athletes.
By origin of the disease, by the nature of its course and other signs, myositis is classified into infectious, purulent and parasitic categories. There are also toxic and traumatic varieties. Poliomyositis( ossifying myositis) is a pathology with the most severe course and ambiguous consequences. This disorder is a disease of connective tissue and, in turn, is classified into:
- traumatic ossifying myositis;
- progressive ossifying myositis;
Traumatic ossifying myositis( the symptoms of the disease will be discussed later) is an inflammatory disease that occurs when there is a strong trauma or repeated repeated microtrauma. The pathology is localized in the articular ligaments and leads subsequently to the appearance of ossification in the problem area. Successfully treated by surgery.
Progressive ossifying myositis( we describe the symptoms of the disease below) is a genetic disease caused by the mutation of a certain gene, leading to severe disorders in the body and, ultimately, to human death. It is considered very rare( no more than 200 cases known world medical practice).
Neurotrophic myositis occurs on the background of injuries of large nerve trunks or spinal cord. Most pathology develops in the knee or hip joint.
As noted earlier, it affects intramuscular nerve fibers. There is it as follows. The inflammatory process leads to the destruction of muscle cells, resulting in the release of various kinds of substances that have a toxic effect on nerve fibers. The nerve shell is gradually destroyed, which leads to the defeat of the axial nerve cylinder.
The signs of a neuromyositis are:
- decrease or increase of sensitivity in the area of pathology localization;
- painful sensations;
- weakness in muscles;
- joint pain.
The destruction of the sheath of nerve fibers causes a change in the sensitivity of the skin. This can be manifested by numbness or tingling, which is accompanied by progressive pain. First, the pain syndrome is moderate, but it is intensified even with insignificant strains. Pain causes breathing, turning or tilting the body, limb movement. Later it makes itself felt even in a state of rest. Often, with pathology, there is a symptom of tension, when it becomes very sensitive to muscle palpation in a stressed state.
Progressive form of the disease
The second type of polymyositis, due to genetic disorders, is a progressive ossifying myositis. Symptoms of pathology are almost impossible to eliminate, because it is considered incurable. With progressive ossifying myositis, ossification of muscles, tendons and ligaments occurs. The disease occurs almost spontaneously and over time covers a large group of muscles. Lethal outcome is inevitable, since the ossification of the pectoral and swallowing muscles deprives the person of the opportunity to eat and breathe. Progressing ossifying myositis has another name - fibrodysplasia ossifying progressive( FOP).
At the heart of the pathology is the onset of the inflammatory process in the tendons, ligaments and muscles, which eventually leads to their ossification. Muscles of the back( wide, trapezius) are subjected to the greatest initial changes with ossifying myositis. What are the consequences of this disease? Serious violations in the functioning of the musculoskeletal system, stiffness of movements, inability to eat normally and breathe - all this significantly reduces the quality of life of the patient. Typically, the process begins in children at the age of ten and progresses over the years, but most of the patients die before they reach the 10-year limit.
Only in 2006, thanks to research conducted by a group of scientists from the University of Pennsylvania, a gene was identified, the mutation of which leads to severe pathology. Today, specialists are developing the blockers of mutations in the gene.
Symptoms of FOP
As mentioned above, FOP occurs as a child. On the possible formation of the disease in the baby may indicate a few signs that arise in the majority of it with ossifying myositis. What are the most obvious symptoms of the disease?
With 95% probability it is possible to diagnose a child's pathology if one or more of the phalanges of the big toe are curved inwards. In some cases, the finger has no joint. Most often progressive myositis is sick boys. Symptom of an ailment in early infancy is painful palpation of the muscles, while they are quite dense, tense.
Another sign of the pathology is swelling of the soft tissues of the head, which could occur with minor bruises or scratches, insect bites. However, in the presence of FOP, puffiness does not respond to drug therapy and does not go on for up to a month. Under the skin in the area of the back, forearm or neck, seals up to 10 cm in size can also occur.
Initially, FOP affects the muscles of the neck, back, head, later descends into the abdominal and femoral parts of the musculature. However, the ailment never affects the muscular tissue of the heart, the diaphragm, the tongue, and the eye-eye muscles.
The disease is often confused with oncology and trying to remove the resulting hardening, which does not lead to recovery, but provokes a rapid growth of "unnecessary" bones.
Unfortunately, to date, progressive ossifying myositis is almost indecisive, and the therapy is ineffective. There are no proven methods of preventing FOP.With the discovery of the mutating gene, it was only possible to study the processes of the onset of the disease. Methods of treatment are developed in the laboratory and do not apply in medical practice. In addition, possible experimental therapies should undergo a serious evaluation of the dosage and duration of treatment.
Specialists who specialize in ossifying myositis work in the USA, at the McKay Lab at the Pennsylvania Federal University. Supervises the scientific work of the doctor of medicine Frederic Kaplan.
In the initial stages of the disease, therapy includes anti-inflammatory drugs, ascorbic acid, vitamins A and B, biostimulants. In severe cases of pathology, steroid hormones are used, although their effectiveness is also not proven.
Some improvements include physical therapy - ultrasound, electrophoresis. These procedures give a resolving and analgesic effect. You should adhere to the minimum intake of products containing calcium, avoid any intramuscular injection. Surgery and removal of bone formations is meaningless.
Traumatic ossifying myositis
Localized traumatic ossifying myositis is a disease that leads to the formation of bone formations as a result of acute injuries - dislocations, fractures, sprains, or due to repeated minor traumatizations, for example, in athletes or musicians.
At the heart of the pathology is a hemorrhage into the muscle tissue. Ossicata are most often formed in the gluteal, hip and shoulder muscles. After some time after the injury, the first symptoms of pathology appear. In the muscle, there is a condensation, which rapidly grows and is painful on palpation. After a few weeks, the densification is transformed into an ossification of an undefined shape, which limits the mobility of the nearby joint. Then the pain gradually disappears. The disease affects young people, most of them men with developed musculature.
Only after carrying out the roentgenogram the diagnosis "traumatic ossifying myositis" is authentically put. An x-ray photo is shown above. The result of the roentgenogram testifies that in the lesion area there is a kind of light "cloud" that does not have clear boundaries. The ossicata that arise in pathology at first do not have a definite shape, but later they acquire a structure and clear contours.
Traumatic ossifying myositis: treatment of
How to eliminate the disease? Traumatic ossifying myositis has favorable prognosis for treatment. Immediately after the injury, the casting of the cast is shown for up to two weeks. After finding the first signs of the disease and establishing the diagnosis, it is necessary to apply light heat, radon baths, X-ray therapy, electrophoresis, and light therapeutic gymnastics. At the same time, massage, paraffin, and electric field can not be used for medicinal purposes.
After the X-ray revealed the presence of cloud cloud shadow, it is still possible to prevent the development of the disease and reverse the process. Under the influence of hormones, resorption occurs. Injections of steroids are carried out locally. Often the treatment uses "Hydrocortisone" in conjunction with the solution of "Novocain."
After a few months after the trauma, when ossification is already formed, conservative treatment does not make sense. Six months later, they resort to surgical intervention - the ossophyte is removed together with the capsule.
There are some conditions that will lead to a positive outcome of therapy and the absence of relapses - the operation should be atraumatic, it is necessary to use an electron knife, carefully suture the wound cavity, and in the postoperative period to perform the prescribed preventive measures.
Diagnosis of ossifying myositis
The detection of the disease begins with the study of the clinical picture. Talking to the patient makes it possible to find out the existence of the last ailments in life, which could become a trigger mechanism for the development of myositis. Often, the pathology occurs due to cystitis, osteomyelitis, erysipelas of the skin. Viruses, bacteria and fungal infections also provoke the development of myositis. The disease is formed and after injuries, muscle cramps, hypothermia. Prolonged loads on certain muscle groups also lead to pathology.
As noted earlier, with ossifying myositis, there is a pain syndrome. Patients often complain of aching pain and muscle weakness. Palpation of the affected parts of the body helps to determine the presence / absence of gravity and nodules in the muscles.
The disease can develop under the influence of toxic substances, for example, with alcoholism and the use of narcotic drugs. Taking certain medications also leads to muscle damage.
examination process In addition to collecting anamnesis and examination, an X-ray is performed to confirm the diagnosis, which allows to detect ossification. Sometimes a CT scan and a radioisotope study of the affected muscles can be performed.
The presence of myositis in the body is indicated by characteristic changes in the general blood test. Another method of laboratory research is the conduct of rheumatic tests, which help determine the nature of the disease and exclude autoimmune diseases, as well as reveal the intensity of the inflammatory process.
Indicators of rheumatropic testify to various states of the body. For example, C-reactive protein is a marker of the acute phase of the inflammatory process. Antistreptolysin-O - a substance that is produced in the body with streptococcal infection. Its presence indicates rheumatism or rheumatoid arthritis. Revmoactor is antibodies that are produced in the body in autoimmune pathologies.
A morphological study in the diagnosis of myositis is a biopsy - taking the biomaterial for analysis and carefully studying it. The main task is to determine the structural changes in muscles and connective tissue.
Prevention of ossifying myositis includes several principles, the main one of which is observance of the right way of life - activity without excessive physical exertion, balanced nutrition and timely treatment of any diseases.
Complete nutrition helps to avoid inflammation in muscles - fatty polyunsaturated acids found in fish are useful;foods high in salicylates( vegetables);easily digestible proteins( almonds, chicken);products containing a large amount of calcium;cereals.
Drinking regimen is very important, with about two liters of water consumed per day. Do not neglect the fruit drinks and compotes, green tea is also useful. To eliminate puffiness, it is recommended to take a broth of dogrose. For the prevention of myositis, it is useful to spend time outdoors. Many patients are often concerned with this question: is it possible to do exercises with ossifying myositis? It is possible, however, the loads should be light and dosed. In addition to gymnastics for this disease recommended hardening, swimming, cycling.
Prevention of myositis also includes a constant movement, it is important not to tolerate hypodynamia and hypothermia of the body. Of course, the best prevention of pathology will be the absence of any injuries.