Diagnostic imaging of heterotopic ossification with coexistent deep-venous thrombosis in flaccid paraplegia

Heterotopic ossification and deep-venous thrombosis can coexist. This raises potential problems because diagnosis depends heavily on imaging studies, and an ideal imaging study which will cost-effectively and noninvasively diagnose both conditions simultaneously is not readily available. A case of coexistent heterotopic ossification and deep-venous thrombosis in flaccid paraplegia is presented. In this case, deep-venous thrombosis and pulmonary embolus were diagnosed and treatment was begun without knowledge of the coexistent heterotopic ossification. Alternative imaging and laboratory diagnostic strategies are discussed. It was concluded that, at this time, clinical acumen and judicious use of traditional diagnostic alternatives is the best means of selecting appropriate treatment. Awareness of the coexistence of the two conditions and careful attention to the patient's clinical course can minimize treatment delays and resultant morbidity.