A 22-year-old man develops a firm, tender swelling in the anterior thigh 4 weeks after a blunt quadriceps contusion. X-ray shows fuzzy calcification within the soft tissue. Which management step is MOST appropriate at this stage?
- A Excision biopsy of the mass to exclude osteosarcoma
- B Aggressive passive stretching to prevent stiffness
- C Gentle active range of motion exercises with analgesia ✓
- D Immediate excision of the matured mass
Correct answer: C. Gentle active range of motion exercises with analgesia
Explanation
This is myositis ossificans traumatica. Early treatment is rest, protection from repeated trauma, analgesia and gentle active movements; forceful passive stretching worsens bleeding and promotes more bone formation. Biopsy is avoided because the cellular mitotic appearance mimics sarcoma and can mislead the pathologist. Excision, if needed at all, is deferred until the lesion matures, typically after 6 to 12 months when it stops growing.
Reference: Apley's System of Orthopaedics and Fractures, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.