Abstract：
We present the case of a child with neuritis ossificans after acute trauma, treated conservatively. The aim of the review is to compare several parameters in this disease. Emphasis is placed on the clinical-radiological features distinguishing neuritis ossificans from malignancy to avoid unnecessary biopsy and surgery.A literature review was performed. Only 18 cases were described. Except for one, all describe adults, and none had acute trauma. Nearly all were treated surgically.Our 13-year-old patient presented with posterior knee pain after trauma. MRI demonstrated a mass within the tibial nerve with oedema, some lymph nodes and increased avidity on 18fluoro-2-deoxyglucose-positron emission tomography. These findings can be reactive but also associated with malignancy. However, eggshell-like calcifications in the periphery of the mass were seen on CT. Biopsy and resection were proposed. Follow-up visits over the next weeks showed remarkable clinical improvement. Wait-and-scan was advised after international discussion. Follow-up imaging after 2 months showed resolution of the oedema and volume reduction of the mass, suggesting a benign pathology. Diagnosis of neuritis ossificans was proposed based on the clinical and radiological features. There was a favorable course with no complaints after two months. Imaging after seven months showed an almost complete regression.Neuritis ossificans should be considered within a painfull (mono)neuropathy. The initial inflammatory phase may mimic malignancy, misleading clinicians toward biopsy or surgery with the risk of nerve damage. As seen in our case, neuritis ossificans can be a self-limiting process. Therefore, conservative therapy should be considered with a wait-and-scan approach.
摘要：
我们介绍了急性创伤后骨化性神经炎儿童的病例，保守对待。审查的目的是比较该疾病的几个参数。重点放在区分骨化性神经炎与恶性肿瘤的临床放射学特征上，以避免不必要的活检和手术。进行了文献综述。仅描述了18例。除了一个,都描述成年人，也没有急性外伤.几乎所有人都接受了手术治疗。我们的13岁患者创伤后出现膝关节后疼痛。MRI显示胫神经内有水肿肿块，18氟-2-脱氧葡萄糖-正电子发射断层扫描显示一些淋巴结和亲和力增加。这些发现可能是反应性的，但也与恶性肿瘤有关。然而,在CT上可以看到肿块周围的蛋壳状钙化。建议进行活检和切除。接下来几周的随访显示出明显的临床改善。经过国际讨论后，建议进行等待和扫描。2个月后的随访影像显示水肿消退，肿块体积减少，提示良性病理。根据临床和放射学特征提出了骨化性神经炎的诊断。有一个良好的课程，两个月后没有投诉。七个月后的成像显示几乎完全消退。骨化性神经炎应考虑在痛性（单一）神经病中。最初的炎症阶段可能模拟恶性肿瘤，误导临床医生进行活检或手术，有神经损伤的风险。从我们的案例中可以看出，骨化性神经炎可能是一个自我限制的过程。因此,保守治疗应考虑采用等待和扫描方法.
