title: Clinical and Genetic Analysis of Fibrodysplasia Ossificans Progressiva: A Case Report and Literature Review.
abstract: Fibrodysplasia ossificans progressiva (FOP) is a rare genetic disorder characterized by congenital malformation of the great toes and disabling heterotopic ossification in specific anatomic locations with a world wide prevalence of 1 in 2 million population. Nearly 90% of patients with FOP are misdiagnosed and mismanaged. We present a case of a four-year-old boy brought by his parents with the complaints of stiffness of right shoulder, neck and multiple swellings over the upper back noted over the past 4 months. On examination bilateral symmetrical hallux valgus with microdactyly of great toes and multiple bony hard swellings on both the scapulae were noted. Skeletal survey revealed all the classical features of FOP. Mutation of the ACVR1gene on genetic analysis confirmed the diagnosis of FOP. Invasive surgical procedures including biopsy and manipulations for stiff joints were avoided as they strikingly end up in rapid progression of FOP. Congenital hallux valgus with short great toe in a child should be considered as an early diagnostic tool for FOP even before the onset of mass lesions. Genetic analysis for mutation of ACVR1gene is confirmatory. Prevention of injury, medical management of acute painful flare-ups and rehabilitation are the mainstay of treatment.
authors.affiliation: Assistant Professor, Department of Orthopaedics, Nizam's Institute of Medical Sciences , Hyderabad, India .
authors.forename: Maheshwar
authors.initials: M
authors.lastname: Lakkireddy
authors.affiliation: Professor, Department of Orthopaedics, Nizam's Institute of Medical Sciences , Hyderabad, India .
authors.forename: Vijaykrishna
authors.initials: V
authors.lastname: Chilakamarri
authors.affiliation: Assistant Professor, Department of Medical Genetics, Nizam's Institute of Medical Sciences , Hyderabad, India .
authors.forename: Prajnya
authors.initials: P
authors.lastname: Ranganath
authors.affiliation: Assistant Professor, Department of Radiology, Nizam's Institute of Medical Sciences , Hyderabad, India .
authors.forename: Abhishek Jagdishchander
authors.initials: AJ
authors.lastname: Arora
authors.affiliation: Research Associate, Diagnostics Division, Centre for DNA Fingerprinting and Diagnostics , Hyderabad, India .
authors.forename: Maria Celestina
authors.initials: MC
authors.lastname: Vanaja
keywords: ACVR1 gene; Congenital hallux valgus; Heterotopic ossification; Iatrogenic Injury; Myositis ossificans progressiva