When Muscle Turns to Bone: A Case Study of Myositis Ossificans in the Upper Extremity

Abstract A 63-year-old female presents after a palpable bulge along her bicep following a fall during an ice storm. She reported pain specifically with elbow flexion and supination of the wrist concerning a bicep injury. Given the palpable deformity, an ultrasound was obtained as there was concern for bicep tendon rupture resulting in retraction of the tendon into the mid-humerus region. However, it demonstrated intramuscular calcifications concern for myositis ossificans of the bicep. Further investigation with magnetic resonance imaging confirmed this conclusion. It was confirmed by ultrasound 18 months later. The age, gender, and mechanism of injury sustained by our patient differs from the normal course of myositis ossificans. Myositis ossificans is typically an athletic injury of a young male athlete located in the lower extremity. A typical presentation is related to trauma with severe contusion to a muscle as might be seen during a tackle in football. However, in our case her injury more so relates to a severe contusion from a fall as we might see in basketball when coming down from a rebound or football when making a catch. Keywords: Myositis ossificans; Biceps; Muscle trauma; Contusion