Myositis ossificans progressiva mimicking ankylosing spondylitis: a case report.

Myositis ossificans progressiva is a rare disorder of young adults characterized by ossification of the connective tissue of the voluntary muscles and ligaments. Although it is trauma-related, up to 40-60% of these patients have no history of previous injury. A young female with marked kyphosis and ankylosis of the spine presented with a recent onset of a rapidly growing painful mass over the anterior aspect of her left shoulder. She received an excisional biopsy but recurrent ossification developed soon after. It then spread to the biceps muscle with subsequent contracture deformities of the shoulder and elbow joints. A plain radiogram of her spine revealed similar characteristics of ankylosing spondylitis. However, the final diagnosis was made by the pathognomonic ectopic ossification of muscles and para-articular soft tissue. Despite poor response of the established constracture, the painful mass did respond well to prednisolone treatment within 2 months, in terms of size and consistency.