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Heterotopic ossification after tetanus
[To cite: Shenoy AD, Shukla A, Bhadra P. Heterotopic ossification after tetanus. Natl Med J India DOI: 10.25259/NMJI_906_2024]
A 21-year-old male presented with progressive difficulty in walking and sitting, with a history of tetanus 2 months ago. On examination, bilateral hip range of motion was restricted, with passive range of motion in right hip flexion was 50°, extension was 10°, abduction was 30° and adduction was 10° and in left hip flexion was 45°, extension was 10°, abduction was fixed at 30° and adduction was 0°. X-ray showed heterotopic ossification in both hips (Fig. 1). Laboratory investigations reported a C-reactive protein of 6.14 mg/dl, alkaline phosphatase of 612 i.u./L, creatine kinase 205.04 U/L and erythrocyte sedimentation rate was 52 mm in 1st hour. He was treated with indomethacin 75 mg sustained release for 6 weeks and gentle range of motion exercise was advised. He was asked to follow up.
- Digital X-ray of the hips and pelvis showing heterotopic ossification in both hips
Heterotopic ossification is a condition in which there is abnormal bone formation in soft tissue. The aetiology can be genetic, traumatic and neurogenic.1 Few cases have been reported with heterotopic ossification post-tetanus infection.2
Conflicts of interest
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References
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