Heterotopic ossification in the hand of a patient with spinal cord injury.

Heterotopic ossification (HO), reported to occur in 20% to 40% of spinal cord injured patients, has been described in the hips, knees, shoulders and elbows, but not in the hands or around the phalangeal joints. This report is believed to be the first of HO of the hand after spinal cord injury. Nine weeks after injury, a diving accident, a 27-year-old man having C6 quadriplegia, motor complete, sensory incomplete, developed acute swelling and loss of range of motion in both hands. Serum alkaline phosphatase showed no significant rise. Bone scan demonstrated increased uptake in many joints of the left hand with x-rays remaining normal. Repeat films three weeks later demonstrated calcific densities adjacent to the midshaft of the proximal phalanx of the left finger. Twice daily range of motion of the hand resulted in improved range of motion. the etiology of HO in spinal cord injured patients remains unknown, and we have no explanation of its occurrence in the hands of this patient.