Heterotopic ossification or unusual foramen in radius?

Gitanjali Khorwal, Sunita Kalra


The interosseous membrane (IOM) runs obliquely from radius to ulna attached to their respective interosseous borders. The membrane provides surface for attachment for muscles; stabilizes the radius and ulna during forearm rotation and actively transmits forces from the radius to the ulna. IOM is an occasional site for heterotopic ossification (HO) that involves development of mature lamellar bone, in a variety of soft tissues such as muscles, ligaments and other soft tissues causing significant functional limitation of upper limb. We describe unusual findings equivocal of congenital or acquired features in a dry adult radius where two thick bony spurs/processes emerging from the middle third of interosseus border approach towards each other joined by a thin bony fragment to form a huge foramen 2.4 cm in length and 6 mm in width abutting an uneven rough area of about 3.6mm x 1.6 mm on anterior surface. A prominent groove leading to a foramen at its junction with the shaft was present on the posterior surface of the bone. Knowledge of such HO as anatomical variants or possible sequel of trauma or neurological insult is indispensible and call for further research and trials to obviate such complications.


Foramen, Fractures, Heterotopic ossification, Interosseous membrane

Full Text:



Standring S, ed. Gray’s Anatomy. 40th Ed., Edinburg, Churchill Livingstone. Elsevier. 2008;839-40.

Noda K, Goto A, Murase T, Sugamoto K, Yoshikawa H, Moritomo H. J Hand Surg Am. Location Interosseous Membrane of the Forearm: An Anatomical Study of Ligament Attachment. 2009;34(3):415-22.

Nakamura T, Yabe Y, Horiuchi Y, Seki T, Yamazaki N. Normal kinematics of the interosseous membrane during forearm pronation-supination--a three-dimensional MRI study. Hand Surg. 2000;5(1):1-10.

Deshpande SH, Desai SD, Kulkarni VN, Bulagouda RS. Heterotopic Osssification in the Interosseous Membrane of right forearm bones. Int J Anat Var. 2013;6:71-3.

Shehab D, Elgazzar AH, Collier BD. Heterotopic ossification. J Nucl Med. 2002;43:346-53.

Ho SSW, Stern PJ, Bruno LP. Pharmacological inhibition of prostaglandin E-2 in bone and its effect on pathological new bone formation in a rat brain model. Trans Orthop Res Soc.1988;13:536.

Chalmers J, Gray DH, Rush J. Observations on the induction of bone in soft tissures. J Bone Joint Surg Br. 1975;57:36-45.

Singh GK, Vikas V. Progressive osseous heteroplasia in a 10-year-old male child. Indian J Orthop. 2011;45:280-2.

Glorieux FH, Rauch F, Plotkin H, Ward L, Travers R, Roughley P, et al. Type V Osteogenesis Imperfecta: A New Form of Brittle Bone Disease. J Bone Min Res. 2000;15:1650-58

Jacobs JE, Birnbaum BA, Siegelman ES. Heterotopic ossification of midline abdominal incisions: CT and MR imaging findings. AJR. 1996;166:579-84.

Reardon MJ, Tillou A, Mody DR, Reardon PR. Heterotopic calcification in abdominal wounds. Am J Surg. 1997;173:145-7.

Haque S, Eisen RN, West AB. Heterotopic formation in gastrointestinal tract. Arch Pathol Lab Med. 1996;120:666-70.

Kumar R, Balachandran K, Kamalanathan S, Sahoo JP. A unique cause of interosseous membrane calcification. BMJ Case Rep. 2015;2015.