" Stiffening of different parts of the body with restricted movements 13 yr.
" Occasional swelling of the muscles of neck, Chest & Back 13 yr.

H/O Present illness : The patient states that she was reasonably healthy thirteen years back . Since that she developed swelling of the neck muscles followed by stiffness with restrected movement of the neck . Swollen area was somewhat painful. After about two weeks swelling subside but muscles become stiff with persisted restricted movement . After about one month another episode of swelling of muscles occur in cheats (Pectoralis) with moderate pain and restricted movement of both arms. In the previous manner swelling subsides residual restricted movement of both arms (especially elevation) along with stiffness of muscles. Again after few months there was swelling of the muscles of back region near chest wall with pain. Few weeks after the onset of swelling , pain subside but stiffness remained in the area of swelling.

H/O Birth : She was born after a normal delivery at home.

Family History:

Father: Diabetic, dead
Mother: Diabetic alive
Brothers: 2, healthy
Sisters: 6, healthy

Treatment history: The patient was admitted in DMCH (Dhaka Medical College Hospital) in the year 1986. A Medical board was formed with distinguished specialist in Medicine, Surgery, Orthopedics, Pediatrics, and Pathology. The diagnosis was mad as Myositis Ossificans Prograssiva & treated with ETIDRONATE DISODIUM 200mg for four months followed by tab Prednisolone 30mg daily for 3 month with a little improvement.

Provisional Diagnosis: Myositis Ossificans Progressiva

Investigations:

" X-rays of the chest, arms, sacroiliac joins showed gross muscles wasting with ossified structure in different muscles (done in 1996).
" Recent X-ray reports are attached herewith.
" Hb%, ESR, TBS, S, Calcium, S. Alkaline Phosphate, S. Phosphate, - attached herewith.
" 24 hr Urine Calcium

Comments:
The patient was reviewed in 1995 in IPGM&R and another board made in the institute advised no further treatment.

For further information
Please Contact

Dr. Sajed Abdul Khaleque
97, Sukrabad, Dhaka 1207
Bangladesh
Tel 880-2-8117024 (res)
E-mail: akhaleq@bttb.net