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Fibrodysplasia ossificans progressiva: a current review of imaging findings

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Abstract

Objective

Fibrodysplasia ossificans progressiva is a rare genetic disorder characterized by congenital skeletal deformities and soft tissue masses that progress to heterotopic ossification. Deformities of the great toes are distinctive, and heterotopic ossification in the soft tissues follows an expected anatomic and temporal pattern. In addition to heterotopic ossification, osteochondromata, middle ear ossification, demyelination, lymphedema, and venous thrombosis are characteristic. Awareness of this constellation of findings is important to early diagnosis and surveillance.

Conclusions

Recognition of the imaging manifestations of fibrodysplasia ossificans progressiva is imperative to early diagnosis in order to appropriately direct patient care and preclude unnecessary biopsies or surgical procedures.

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References

  1. Hagiwara H, Aida N, Machida J, et al. Contrast-enhanced MRI of an early preosseous lesion of fibrodysplasia ossificans progressiva in a 21-month-old boy. AJR Am J Roentgenol. 2003;181(4):1145–7.

    Article  PubMed  Google Scholar 

  2. Reinig JW, Hill SC, Fang M, et al. Fibrodysplasia ossificans progressiva: CT appearance. Radiology. 1986;159(1):153–7.

    Article  PubMed  CAS  Google Scholar 

  3. Kaplan FS. Fibrodysplasia ossificans progressive. Best Pract Res Clin Rheumatol. 2008;22(1):191–205.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  4. Rajapakse CS, Lindborg C, Wang H, et al. Analog method for radiographic assessment of heterotopic bone in fibrodysplasia ossificans progressiva. Acad Radiol. 2017;24(3):321–7.

    Article  PubMed  Google Scholar 

  5. https://ghr.nlm.nih.gov/primer/basics/gene. 12/16/2017.

  6. Kaplan FS, Xu M, Seemann P, et al. Classic and atypical fibrodysplasia ossificans progressiva (FOP) phenotypes are caused by mutations in the bone morphogenetic protein (BMP) type I receptor ACVR1. Hum Mutat. 2009;30(3):379–90.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  7. Shafritz AB, Shore EM, Gannon FH, et al. Overexpression of an osteogenic morphogen in fibrodysplasia ossificans progressiva. N Engl J Med. 1996;335(8):555–61.

    Article  PubMed  CAS  Google Scholar 

  8. Cremin B, Connor MJ, Beighton P. The radiological spectrum of fibrodysplasia ossificans progressiva. Clin Radiol. 1982;33:499–508.

    Article  PubMed  CAS  Google Scholar 

  9. Mahboubi S, Glaser DL, Shore EM, et al. Fibrodysplasia ossificans progressiva. Pediatr Radiol. 2001;(5):307–14.

  10. Deirmengian GK, Hebela NM, O’Connell M, et al. Proximal tibial osteochondromas in patients with fibrodysplasia ossificans progressiva. J Bone Joint Surg Am. 2008;90(2):366–74. https://doi.org/10.2106/JBJS.G.00774.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Cohen RB, et al. The natural history of heterotopic ossification in patients who have fibrodysplasia ossificans progressiva: a study of forty-four patients. JBJS. 1993;75(2)

  12. Kan L, Kitterman JA, Procissi D, et al. CNS demyelination in fibrodysplasia ossificans progressiva. J Neurol. 2012;259(12):2644–55.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  13. Shiva Kumar R, Keerthiraj B, Kesavadas C. Teaching NeuroImages: MRI in fibrodysplasia ossificans progressiva. Neurology. 2010;74(6):e20.

    Article  PubMed  CAS  Google Scholar 

  14. Levy CE, Lash AT, Janoff HB, et al. Conductive hearing loss in individuals with fibrodysplasia ossificans progressiva. Am J Audiol. 1999;8(1):29–33.

    Article  PubMed  CAS  Google Scholar 

  15. Janoff HB, Zasloff MA, Kaplan FS. Submandibular swelling in patients with fibrodysplasia ossificans progressiva. Otolaryngol Head Neck Surg. 1996;114(4):599–604.

    Article  PubMed  CAS  Google Scholar 

  16. Kaplan FS, Zasloff MA, Kitterman JA, et al. Early mortality and cardiorespiratory failure in patients with fibrodysplasia ossificans progressiva. J Bone Joint Surg Am. 2010;92(3):686–91.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Kaplan FS, Shore EM, Pignolo RJ, Hsiao EC, The International Clinical Consortium on FOP. The medical management of fibrodysplasia ossificans progressiva: current treatment considerations. Clin Proce Intl Clin Consort FOP. 2011;4:1–100.

    Google Scholar 

  18. Pignolo RJ, Shore EM, Kaplan FS. Fibrodysplasia ossificans progressiva: clinical and genetic aspects. Orphanet J Rare Dis. 2011;6:80.

    Article  PubMed  PubMed Central  Google Scholar 

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Correspondence to Adam H. Bauer.

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Disclosure

Edward C. Hsiao receives clinical research funding from Clementia Pharmaceuticals to support clinical trials in FOP. This does not pose a conflict of interest for this project.

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The authors declare that they have no conflicts of interest.

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Bauer, A.H., Bonham, J., Gutierrez, L. et al. Fibrodysplasia ossificans progressiva: a current review of imaging findings. Skeletal Radiol 47, 1043–1050 (2018). https://doi.org/10.1007/s00256-018-2889-5

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  • DOI: https://doi.org/10.1007/s00256-018-2889-5

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