The patient was also found to have high PTH levels, subclinical hypothyroidism, and heterotopic ossifications. While patients with AHO are usually obese, the BMI level of our patient was in the underweight group according to the World Health Organization guidelines.
The cumulative effect of the heterotopic ossification leads to severe disability which leads to being wheelchair ridden by the end of the third decade of life and ultimately death due to thoracic insufficiency syndrome.
Barden, "Limited range of motion caused by heterotopic ossifications in primary total knee arthroplasty: a retrospective study of 27/191 cases," Archives of Orthopaedic and Trauma Surgery, vol.
Various factors have been identified as being causes of suprascapular nerve entrapment including the variations in the suprascapular notch along with the variations of suprascapular ligament ossifications.
The radiographs of the affected extremity (Figure 1) reveal fine granular densities that represent ossifications in the subcutaneous tissue, independent of the veins, and can be further confirmed on venography.