Heterotopic Ossification and DVT

Question 1

Anticoagulants are generally withheld for ________ after acute SCI

Answer 1

First 72 hours

Question 2

Gold standard for PE Dx

Answer 2

Pulmonary arteriogram

Question 3

When is most common time frame after SCI for onset of HO

Answer 3

1-4 months post-injury

Question 4

Is HO circumscribed or noncircumscribed? Extra-articular or intra-articular? Extracapsular or intracapsular?

Answer 4

No circumscribed, extra-articular, extracapsular

Question 5

What medication and dose is used for HO prophylaxis

Answer 5

Eitdronate 20mg/kg/day x 2 weeks, and then 10mg/kg/day x 10 weeks

Question 6

What is timeframe for greatest risk of DVT formation after SCI?

Answer 6

1-2 weeks post-injury

Question 7

Leading cause of death in acute SCI

Answer 7

Pulmonary Embolism

Question 8

How long should anticoagulants be continued in an incomplete SCI patient that is ambulating

Answer 8

Until discharge

Question 9

MOA of bisphosphonates

Answer 9

Binds to hydroxyapatite crystals in bone and inhibits osteoclast-mediated bone resorption

Question 10

How long should anticoagulants be continued in a complete complicated SCI patient

Answer 10

At least 12 weeks post-injury

Question 11

Gold standard for Dx of HO

Answer 11

Bone scan

Question 12

Gold standard for DVT Dx

Answer 12

Venogram

Question 13

How long should anticoagulants be continued in a complete uncomplicated SCI patient

Answer 13

At least 8 weeks post-injury

Question 14

4 most common locations of HO in SCI patients, in descending order

Answer 14

Hip, knee, shoulder, elbow

Question 15

Treatment medication and dose for HO

Answer 15

• Etidronate 20mg/kg/day x 3 months, then 10mg/kg/day x 3 months
• Indomethacin 75mg QD x 6 weeks

Question 16

Functional e-stim is most effective for what kind of patients

Answer 16

UMN injuries with preservation of anterior horn cells and motor nerve root