PMC6262803_01
Preoperative appearance showing the mass and the overlying skin erythema.
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A 30-year-old female presented with a 5-week history of a painful rapidly-growing mass over the proximal phalanx of the right ring finger (Fig. 1).
Magnetic resonance T1- weighted image showing an iso-intense lesion.
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T1-weighted images (Fig. 2). T2-weighted images showed high intensity in the center of the lesion and low intensity at the periphery of the lesion (Fig. 3).
Magnetic resonance T2- weighted image showing high intensity in the center and low intensity at the periphery of the lesion.
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T1-weighted images (Fig. 2). T2-weighted images showed high intensity in the center of the lesion and low intensity at the periphery of the lesion (Fig. 3).
Intraoperative view of the lesion. The flexor sheath and the checkrein ligament of the proximal interphalangeal joint were infiltrated by the tumor. The common digital artery of the 3rd web space was obliterated (within the tumor). The digital nerve was stretched and attenuated (arrow).
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The radial digital nerve of the ring finger was stretched and attenuated (Fig. 4).
Excision of the mass required excision of the flexor sheath, the checkrein ligament, and the common digital artery. Note the preserved digital nerve (arrow).
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The digital nerve was preserved (Fig. 5, Fig. 6).
Histology showing the classic 3 zones of myositis ossificans: I: Central cellular fibroblastic zone, II: Osteoid Zone, III: Zone of mature bone trabeculae.
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Histology showed the classic 3 histological zones of myositis ossificans: a central cellular / fibroblastic zone, an intermediate zone of osteoid (immature bone) and an outer zone of mature bone (Fig. 7).
Active motion at 1 year after surgery. A: Active extension, B: Active flexion.
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At final follow up, there was full flexion of the digit, but the proximal interphalangeal joint had an extension lag of 30o (Fig. 8).