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Case Report · Open access

A rare mass with atypical localization: Heterotopic ossification associated with flexor hallucis longus

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Muhammed Köroğlu

Department of Orthopedics and Traumatology, İnönü University Faculty of Medicine, Malatya, Türkiye

ORCID: 0000-0003-4706-2308

Mustafa Karakaplan

Department of Orthopedics and Traumatology, İnönü University Faculty of Medicine, Malatya, Türkiye

ORCID: 0000-0001-9035-0319

Hüseyin Utku Özdeş

Department of Orthopedics and Traumatology, İnönü University Faculty of Medicine, Malatya, Türkiye

ORCID: 0000-0003-4437-9860

Zeynep Maraş Özdemir

Department of Radiology, İnönü University Faculty of Medicine, Malatya, Türkiye

ORCID: 0000-0003-1085-8978

Abstract

Heterotopic ossification (HO), characterized by the formation of ectopic bone, is a benign mass observed in soft tissues. Depending on its location, it can cause symptoms beyond compression, such as mechanical blockage when associated with joints, leading to limitations in joint movements. In the majority of cases, involvement of the hip and elbow joints is common, while HO can sometimes be observed in atypical locations. Trauma, head injury, and spinal cord injuries are well-recognized risk factors for HO development. However, on rare occasions, in non-traumatic cases are identified without any known risk factors. Herein, we present a rare non-traumatic HO case associated with the flexor hallucis longus (FHL) tendon in a 58-year-old female patient. She complained of pain under the first toe of her right foot while wearing shoes for a year, and a mass was detected on the plantar surface of the foot along with limitation of movement in the first metatarsophalangeal joint. Further examinations revealed that the identified mass was a mature HO lesion. Surgical treatment was performed, and during one-year follow-up, the pain subsided, and joint movements returned to normal, resulting in a satisfactory outcome. In conclusion, although many cases of HO are associated with traumatic injuries, it can sometimes be idiopathic, as in our case, and rarely it is accompanied tendon such as FHL in the foot.

Declarations

Informed Consent

A written informed consent was obtained from the patient.

Author Contributions

Conception, design, data collection and/or processing: M.K.; Conception, supervision, analysis: M.K.; Writing, literature review: H.U.Ö.; Materials, design: Z.M.Ö.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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