Korean J Neurotrauma.  2015 Oct;11(2):158-161. 10.13004/kjnt.2015.11.2.158.

Leg Swelling Caused by Heterotopic Ossification Mimicking Deep Vein Thrombosis in a Paraplegic Patient

• Bang JH
• Cho KT
• Lee HJ

• KMID: 2378278
• DOI: http://doi.org/10.13004/kjnt.2015.11.2.158

Abstract

Leg swelling in patients with paraplegia due to spinal cord injury (SCI) occurs for various reasons, including heterotopic ossification (HO), deep vein thrombosis (DVT), fracture, or cellulitis. The clinical presentations of these conditions may overlap in part or in whole and it may occasionally be difficult to distinguish. Of these conditions, DVT and subsequent pulmonary embolism remain significant causes of morbidity and mortality in patients with SCI. Therefore, a prompt diagnostic work-up, particularly for DVT, is essential in patients with SCI, who present with leg swelling. Here, we report a case of leg swelling in a paraplegic patient, resulting from HO mimicking DVT and discuss the differential diagnosis.

Keyword

Ossification, heterotopic; Venous thrombosis; Spinal cord injuries; Paraplegia

MeSH Terms

Cellulitis
Diagnosis, Differential
Humans
Leg*
Mortality
Ossification, Heterotopic*
Paraplegia
Pulmonary Embolism
Spinal Cord Injuries
Venous Thrombosis*

Figure

• 

  FIGURE 1 Computed tomography venography of the lower extremities. A: Coronal source image of venography shows heterotopic ossification (HO) (white arrow) and narrowing of the left external iliac vein (EIV) (black arrow) compared to the right vein (arrowhead). B: Axial source image of venography shows HO (white arrow) located anteromedial to the femur and displaces the iliopsoas muscle anteromedially (asterisk). Narrowing of the diameter of left EIV (black arrow) is noted compared to the right vein (arrowhead). C: Three-dimensional reconstruction image shows HO (white arrows) located anteromedial to the femur. Narrowing of the left EIV (black arrow) compared to the right vein (arrowhead) under the region where the inguinal ligament runs is noted.

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