A Rare Presentation of Myositis Ossificans in a Diabetic Individual

INTRODUCTION: Myositis ossificans (MO) is a disease with self-limiting, benign ossifying lesions. MO traumatica is most common cause and occurs after blunt trauma to muscle tissue and the most common site of occurrence is the anterior thigh often developing after an intramuscular hematoma. The pathophysiology of MO is not well understood. The association of myositis and diabetes is quite rare. CASE REPORT: A 57-year-old male presented with a discharging ulcer on the right lateral lower leg. A radiograph was carried out to ascertain the degree of bone involvement. However, the X-ray showed calcifications. Ultrasound, magnetic resonance imaging (MRI) and X-ray imaging were used to exclude malignant disorders such as osteomyelitis or osteosarcoma. The diagnosis of myositis ossificans was confirmed with MRI. As the patient had a background of diabetes, this could have led to MO as a result of the macrovascular complication of a discharging ulcer; hence, diabetes could be considered a risk factor for the disease. CONCLUSION: The reader may appreciate that diabetic patients may present with MO and that repeated discharging ulcers may imitate the effects of physical trauma on calcifications. The specific take home message is that regardless of the apparent rarity of a disease and subversion to typical clinical presentation, it should still be considered. Furthermore, the exclusion of severe and malignant diseases which benign diseases may mimic is of utmost importance to correctly manage patients.