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Observational Study
. 2021 Jun;59(6):635-641.
doi: 10.1038/s41393-020-00539-8. Epub 2020 Sep 1.

Pelvic MRI in spinal cord injury patients: incidence of muscle signal change and early heterotopic ossification

David McKean  1 , Sarim Ather  2 , Amar Gandhi  2 , Talia Hubble  2 , Maurizio Belci  3 , Simone Tiberti  3 , Joseph Papanikitas  4 , Sarah Yanny  4 , Deborah King  4 , Richard Hughes  4 , Thomas Meagher  4 , Luis Lopez de Heredria  3
Affiliations
Observational Study

Pelvic MRI in spinal cord injury patients: incidence of muscle signal change and early heterotopic ossification

David McKean et al. Spinal Cord. 2021 Jun.

Abstract

Study design: Prospective observational study.

Objective: To evaluate pelvic MRI muscle signal changes and their association with early heterotopic ossification (HO) in patients with spinal cord injuries.

Setting: National Spinal Injuries Unit, Stoke Mandeville, UK.

Methods: Forty patients were imaged with at least two interval magnetic resonance (MR) studies of the pelvis in the first 6 months following a spinal cord injury. Scans were reviewed and scored for heterotopic ossification, muscle signal change and extent of muscle involvement.

Results: Muscle signal change was present in 28 (70%) on the initial MRI and 31 (77%) by the second study. Six patients developed MR changes of prodromal or immature heterotopic ossification (15%). No restricted diffusion was demonstrated and no patient developed mature HO. Patients developing MR changes of early HO were more likely to have grade 3 muscle changes.

Conclusion: Increased T2 muscle signal is common following cord injury, is frequently progressive in the subacute period and is associated with complete injury and early MR signs of heterotopic ossification.

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