Ossificações heterotópicas – A propósito de um caso clínico

Heterotopic ossifications (HO) are bony formations in non-skeletal tissue that may occur in traumatic and/or neurological disorders. The diagnosis is based on clinical signs and symptoms, completed with lab tests and imagiologic tests. The most common used drugs to prevent and treat this entity are the bisfosphonates and the NSAID’s. Rehabilitation has an important role in optimizing the function of the affected areas. In this work the authors present the case report of a 54 year old male that suffered a traffic accident in 23/8/2010 with TBI and severe toraco-abdominal trauma. Physical examination in 8/11/2010 showed severe pain (VAS 8) on the mobilization of the left shoulder. Painful right knee (VAS 8) with 30o flexion, -20o extension. Walking was only possible with the help of a third person. The exams revealed 2 large and metabolically active HO, one on the left shoulder and the other on the right knee. Under physiatrist’s responsibility, he started Rehabilitation management and medication with oral corticoid, NSAID and bisphosfonate. After the treatment the patient was discharged in 28/1/2011, independent in the ADL and walking, with mild pain (VAS 3) and limitation of the movements of the left shoulder. Keywords: Ossification; Heterotopic; Rehabilitation; Wounds and Injuries.