PMC4897328_01
26-year-old man with polytrauma who developed mesenteric ossification. CT scan one week after the initial trauma shows retroperitoneal hematoma and open mid-line abdominal wound to relieve abdominal compartment syndrome.
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The patient's CT scan one week post-trauma showed no signs of ossification (Fig. 1).
26-year-old man with polytrauma who developed mesenteric ossification. AP pelvis radiograph 10 months after initial trauma showing bony densities at the insertion site of the right femoral IM rod, overlying the left hip, overlying the symphysis pubis, and overlying the lower abdomen.
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Ten months after the initial trauma, as part of an evaluation for left hip stiffness, the patient had radiographs of the pelvis that demonstrated densities around both hips and over the lower abdomen (Fig. 2).
26-year-old man with polytrauma who developed mesenteric ossification. Axial noncontrast CT shows extra-articular fusion of the left hip by heterotopic ossification.
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On CT, these densities had a well-defined cortex and internal trabecular structure, indicative of mature bone (Figure 3, Figure 4). The left hip stiffness was found to be the result of heterotopic bone bridging the greater trochanter and the posterior acetabular wall (Fig. 3).
26-year-old man with polytrauma who developed mesenteric ossification. (A) Axial noncontrast CT demonstrates a large ventral hernia filled with bowel and covered by a skin graft. In the mesenteric fat, there are multiple linear branching opacities that appear conticated and trabeculated, separate from the bowel or abdominal wall (arrows). (B) Coronal CT reformation demonstrates the superior inferior orientation of the heterotopic ossification (arrows). (C) Sagittal CT reformation demonstrates the craniocaudal orientation of the heterotopic ossification (arrows). (D) Bone settings shows the cortical and trabecular structure of the mesenteric heterotopic ossification (arrows).
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On CT, these densities had a well-defined cortex and internal trabecular structure, indicative of mature bone (Figure 3, Figure 4). The abdominal densities were demonstrated to be within the small bowel mesentery, and had the morphology of branching sheets (Fig. 4).