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Power Doppler usage for early diagnostics and follow up of post-traumatic myositis ossificans: a case report

The purpose of this case report is to describe the phases of the post-traumatic myositis ossificans (PTMO) by using high resolution ultrasound (HRUS), power Doppler, radiography and multislice computed tomography (MSCT). The case report is based on a spastically quadriplegic 17-year-old patient who developed PTMO of both hips and shoulders after a severe traumatic brain injury (TBI). The follow up consisted of using imaging methods 3, 6 and 9 months after injury. In the early stages of the PTMO, the high-resolution ultrasound (HRUS) in B mode showed heterogeneous areas with surrounding hypoechoic soft tissue and hyperechoic core. Positive power Doppler signal was also detected. With the maturing of the lesions, a peripheral lamellar calcification and posterior acoustic shadow became visible, along with positive power Doppler signal. The lesions, which show a completely calcified periphery with acoustic shadow and negative power Doppler signal, are considered mature. In our study, we noted the positive power Doppler signal in the first and second stage of the follow up, while it was negative 9 months after the injury. The ultrasound examination is especially useful in the early stages, when there is no positive signal on radiograms, and in estimating the maturity of the lesion. We recommend the usage of the power Doppler for early diagnosis and the estimation of the maturity of the ossification.

post-traumatic myositis ossificans ; power Doppler ; ultrasound ; radiography ; computed tomography

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