Deformity of the great toe in fibrodysplasia ossificans progressiva

2010 ◽  
Vol 15 (6) ◽  
pp. 804-809 ◽  
Author(s):  
Yasuharu Nakashima ◽  
Nobuhiko Haga ◽  
Hiroshi Kitoh ◽  
Junji Kamizono ◽  
Koji Tozawa ◽  
...  
2017 ◽  
Vol 60 (7) ◽  
pp. 399-402 ◽  
Author(s):  
O. Will Towler ◽  
Eileen M. Shore ◽  
Meiqi Xu ◽  
Abbey Bamford ◽  
Ilse Anderson ◽  
...  

2019 ◽  
Vol 248 (5) ◽  
pp. 396-403 ◽  
Author(s):  
Laura Hildebrand ◽  
Mareen Schmidt‐von Kegler ◽  
Maria Walther ◽  
Petra Seemann ◽  
Katja Stange

2021 ◽  
Author(s):  
Maria Kirstine Møller - Madsen ◽  
Darko Antičević

Abstract Background: Fibrodysplasia ossificans progressiva (FOP) is an ultra-rare and severely disabling genetic disorder. The worldwide prevalence is approximately 1 per 2 million. Heterozygous mutations in ACVR1/ALK2 gene exist in all sporadic and familial cases of FOP. The primary aim of this study is to describe the clinical course of three children suffering from FOP and followed for fifteen, twenty-two and forty years, respectively Secondary aim is to provide clinical advice on how to diagnose the condition with special reference to the great toes malformation and give current best therapeutic approaches.Results: All three cases characterized with malformed great toes initially followed by progressive loss of mobility for a period from fifteen to forty years. Conventional radiology indicates the diagnosis and RNA/DNA test confirm it.Conclusion: Congenital malformation of the great toes in early childhood may be the first clinical sign of FOP. A devastating disease due to its progressive formation of heterotopic ossifications in soft tissue even after minor injuries. Leading to progressive immobility, skeletal deformities, chronic pain, growth defects and disabling joint stiffness. No curative treatment exists today. Management is symptomatic combined with a prophylactic lifestyle avoiding blunt and pointed trauma including surgery.


2016 ◽  
Vol 54 (202) ◽  
pp. 91-93 ◽  
Author(s):  
Ankur Singh ◽  
Gaurav Pradhan ◽  
Chandravati Kumari ◽  
Seema Kapoor

Fibrodysplasia ossificans progressiva is a rare disorder of heterotopic ossification. Procedures like biopsy and surgery are known to be aggravating factors in promoting heterotopic ossification Clues to clinical diagnosis may therefore be a great advantage to treating orthopedician. Valgus deformity of great toe is an important diagnostic clue for treating physicians and thus aids in preventing the clinicians from subjecting the patients to unnecessary invasive and traumatic procedures. Hence clinical clues to early diagnosis are important in establishing the correct diagnosis and directing future management. Keywords: fibrodysplasia ossificans progressiva; valgus deformity of greater toe. | PubMed


1970 ◽  
Vol 28 (4) ◽  
Author(s):  
Daniel Solomon ◽  
Iyasu Wakjira ◽  
Daniel Hailu ◽  
Yocabel Gorfy

BACKGROUND: Fibrodysplasia ossificans progressiva (FOP), also known as Myositis ossificans progressiva or Munchmeyer's disease, is an extremely rare and disabling genetic condition of congenital skeletal malformations and progressive heterotopic ossification (HO). The disease is characterized by congenital skeletal anomalies and progressive ectopic bone formation in connective tissues such as ligaments, muscles and tendons. The disease has an incidence of about 1 in 2 million population.CASE DETAILS: We report a case of a 2-year and 8-month old male child with an initial diagnosis of soft tissue sarcoma based on fine needle aspiration (FNAC) of neck swelling.CONCLUSION: Fibroplasia ossificans progressive (FOP) characteristically manifests with bilateral malformation of the great toe and progressive heterotopic ossification (HO). Clinicians and radiologists should be aware of these to prevent permanent disability.KEYWORDS: Fibroplasia ossificans progressive, myositis ossificans


2020 ◽  
Vol 2 ◽  
pp. 69-72
Author(s):  
M. Dhivakar ◽  
Anjali Prakash ◽  
Anju Garg ◽  
Ayush Agarwal

Fibrodysplasia ossificans progressiva (FOP) is an extremely rare skeletal dysplasia with characteristic imaging and clinical findings, which includes bilateral hallux valgus, monophalangic great toes with short and stout first metatarsals, heterotopic ossification of muscles and connective tissues, short broad femoral necks, pseudo exostoses, short and stout first metacarpals, C2-C7 facet joint fusion, large posterior elements, and tall narrow vertebral bodies. We present a case of an 8-year-old male child who came with complaints of multiple progressive hard swellings over the neck, chest, and abdomen with restriction of movements for a duration of 2 years and deformity of great toe on both sides since birth. On clinical examination, the patient had multiple non-tender hard bony swellings in neck, chest, and abdominal wall with bilateral hallux valgus deformity. Radiographic examination revealed well- defined rib-like ectopic osseous outgrowths in the posterior aspect of neck, soft tissues of chest and abdominal wall, bilateral hallux valgus, monophalangic great toe and short first metatarsals with normal cervical vertebral bodies, posterior elements, short first metacarpals bilaterally, and pseudo exostoses in medial aspect of upper one-third of both tibia. With the above classic findings, the diagnosis of FOP was made. Early diagnosis of the condition is very important in these cases as intramuscular injections, biopsies, and trivial trauma can exacerbate the condition with painful flare-ups.


Author(s):  
O. Will Towler ◽  
Frederick S. Kaplan ◽  
Eileen M. Shore

Fibrodysplasia ossificans progressiva (FOP) is a rare genetic disorder in which extensive heterotopic ossification (HO) begins to form during early childhood and progresses throughout life. Although HO does not occur during embryonic development, children who carry the ACVR1R206H mutation that causes most cases of FOP characteristically exhibit malformation of their great toes at birth, indicating that the mutation acts during embryonic development to alter skeletal formation. Despite the high prevalence of the great toe malformation in the FOP population, it has received relatively little attention due to its clinically benign nature. In this study, we examined radiographs from a cohort of 41 FOP patients ranging from 2 months to 48 years of age to provide a detailed analysis of the developmental features, progression, and variability of the great toe malformation of FOP, which include absent skeletal structures, malformed epiphyses, ectopic ossification centers, malformed first metatarsals and phalangeal fusion.


1983 ◽  
Vol 2 (3) ◽  
pp. 499-505 ◽  
Author(s):  
Justin Howse
Keyword(s):  

2018 ◽  
Vol 27 (04) ◽  
pp. 215-221
Author(s):  
R. Morhart ◽  
O. Semler ◽  
L. Seefried

ZusammenfassungBei der Fibrodysplasia ossificans progressiva (FOP) besteht aufgrund einer aktivierenden Mutation im Gen für den Activin A Rezeptor Typ 1 (ACVR1 / ALK2), eine Prädisposition zu heterotoper Knochenbildung in Weichgeweben, insbesondere der Muskulatur. Die Prävalenz der Erkrankung wird in einer Größenordnung von 1 pro 1–2 Mio. angegeben. Klinisch kommt es intrauterin zu Fehlbildungen, z. B. zu einem bds. Hallux valgus, der bei der überwiegenden Mehrheit der Patienten bereits bei Geburt besteht. Postnatal kommt es meist in den ersten Lebensjahren beginnend im Schulter-/ Nackenbereich episodenartig bereits nach kleineren Verletzungen zu schmerzhaften Weichteilreaktionen, sogenannten flareups die nachfolgend im Sinne einer enchondralen Ossifikation verknöchern. Die Akkumulation dieser irreversiblen Verknöcherungen im Weichgewebe bedingt eine zunehmende Einschränkung der Beweglichkeit bis hin zur kompletten Einsteifung des Körpers. Letztlich kommt es durch die fortschreitende Rigidität des Thorax zu einer respiratorischen Insuffizienz und kardialer Dekompensation.Therapeutisch steht im Vordergrund die Vermeidung von Traumata als Auslöser für die Entstehung extraossären Knochengewebes, insbesondere auch der Verzicht auf unnötige iatrogene Schädigungen durch Operationen, Biopsien und intramuskuläre Injektionen. Supportiv sind eine adäquate Hilfsmittelversorgung, psychologische Unterstützung und eine analgetische Versorgung erforderlich. Im Falle eines Traumas werden kurzfristig hochdosiert Glucocorticoide empfohlen, um das Risiko und Ausmaß der flare-ups und nachfolgender Verknöcherungen zu reduzieren. Ergänzend können NSAR hilfreich sein. Derzeit werden unterschiedliche neue Therapieansätze entwickelt. Am weitesten fortgeschritten ist dabei der Retinolsäure Rezeptor Gamma (RARg) Agonist Palovarotene, der durch Interferenz mit der ALK2 vermittelten Signalkaskade einen zentralen Punkt im Pathomechanismus der Erkrankung adressiert.


2019 ◽  
Author(s):  
Lily Huang ◽  
Chris Schoenherr ◽  
Lili Wang ◽  
Xialing Wen ◽  
Joyce McClain ◽  
...  

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