title: Severe heterotopic ossification in the non-affected limbs of  a hemiplegic patient with traumatic brain injury.
abstract: OBJECTIVE
  Heterotopic ossification characterized by new bone formation in the periarticular regions of large joints in patients with neurologic injury most commonly occurs on the neurologically involved side. This study presents a very rare localization of heterotopic ossification that developed in the non-paretic limbs of a hemiplegic patient with traumatic brain injury (TBI).
  
  
  METHODS
  A 25-year-old left hemiplegic male with TBI due to a gunshot wound was admitted to the rehabilitation centre after a 2.5-month period of coma in the intensive care unit. He had limited range of motion accompanied by pain in the bilateral hip, bilateral elbow and right knee joints. Neurological examination revealed upper motor neuron lesions only on the left side in neurological exam. Plain radiographs of the involved joints revealed bilateral heterotopic ossification, which was more severe on the non-paretic side.
  
  
  CONCLUSIONS
  Clinicians should keep in mind that heterotopic ossification can occur in non-hemiplegic extremities as well as hemiplegic extremities in patients with TBI in whom the extent of neurologic damage cannot be definitely established.
authors.affiliation: Gülhane Military Medical Academy, Department of Physical Medicine and Rehabilitation, Turkish Armed Forces Rehabilitation Center, Ankara, Turkey. serdarkb@gmail.com
authors.forename: Serdar
authors.initials: S
authors.lastname: Kesikburun
authors.forename: Özlem Köroğlu
authors.initials: ÖK
authors.lastname: Omaç
authors.forename: Evren
authors.initials: E
authors.lastname: Yaşar
authors.forename: Bülent
authors.initials: B
authors.lastname: Hazneci
authors.forename: Ridvan
authors.initials: R
authors.lastname: Alaca
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000150:complications / Q000000981:diagnostic imaging*; D006429:Hemiplegia / Q000150:complications / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D009999:Ossification, Heterotopic / Q000000981:diagnostic imaging* / Q000209:etiology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome