Heterotopic ossification (HO) is the presence of bone in soft tissues where bone does not normally exist. It is acquired most often from musculoskeletal trauma, spinal-cord injury or central nervous system injury. Patients who have undergone total elbow replacement are therefore at risk for HO. Patients can present with fever, swelling, erythema, and joint tenderness, thus making it difficult to distinguish from cellulitis or osteomyelitis. Conventional radiography and 3-phase bone scanning can be used to confirm the diagnosis of HO. The appearance of HO on radiographic imaging is described as circumferential ossification with a lucent center. Diphosphonates and nonsteroidal anti-inflammatory drugs are used for the phrophylaxis and treatment of HO.
Heterotopic ossification bridging the elbow joint anteriorly.