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Magnetic resonance imaging (MRI) or computed tomography (CT) of the pelvis was performed if there were clinical and laboratory signs of NHO and sonographic evidence of edema and\/or calcifications in the tissue around the hip joint. If NHO were detected, tissue was obtained and preserved for histological examination from the involved tissue around the hip joint affected by NHO and from an unaffected calf as control. Nine participants with a complete spinal cord lesion American Spinal Injury Association Impairment Scale (AIS) grade A and evidence of an acute NHO in the hip joint muscles were recruited for the study.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>In all sonographic examinations of the hip joint, edematous changes could be detected. In one case, calcifications were detected sonographically. In MRI\/CT in six participants, ossification could already be detected. All histological specimens from the NHO-affected gluteal region showed varying degrees of tissue deformation. The unaffected reference samples showed regular muscular structure microscopically.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>It was possible to show and compare histological changes in NHO-affected tissue with MRI\/CT imaging, depending on the stage of NHO.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Trial registration<\/jats:title>\n            <jats:p>DRKS, DRKS00034049. Registered 12 April 2024 - Retrospectively registered, <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.drks.de\/DRKS00034049\" ext-link-type=\"uri\">https:\/\/www.drks.de\/DRKS00034049<\/jats:ext-link>.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1038\/s41393-025-01070-4","type":"journal-article","created":{"date-parts":[[2025,3,13]],"date-time":"2025-03-13T10:59:04Z","timestamp":1741863544000},"page":"227-232","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Histology of neurogenic heterotopic ossification and comparison with its radiological expression in acute spinal cord injured patients"],"prefix":"10.1038","volume":"63","author":[{"given":"Eugen","family":"Ulrich","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Brinkemper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manfred","family":"K\u00f6ller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingo","family":"Stricker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid","family":"Gisevius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas A.","family":"Schildhauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renate","family":"Meindl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis","family":"Grasm\u00fccke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabrina","family":"Buche-Lyding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volkmar","family":"Nicolas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirko","family":"Aach","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,3,13]]},"reference":[{"key":"1070_CR1","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1007\/s10195-012-0193-z","volume":"13","author":"AF Mavrogenis","year":"2012","unstructured":"Mavrogenis AF, Guerra G, Staals EL, Bianchi G, Ruggieri P. 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The participants were instructed about the objectives and the course of the study and provided written consent. We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statement of ethics"}},{"value":"Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed patient consent"}}]}}