• Youngmin Kim, Sook Joung Lee, Eunseok Choi, Sangjee Lee, Jungsoo Lee, and Eunjin Park.
• Department of Physical Medicine and Rehabilitation, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea.
• Medicine (Baltimore). 2022 Oct 28; 101 (43): e31628e31628.

RationaleHeterotopic ossification (HO), an ectopic bone formation in soft tissue around the joint, is a complication observed in stroke patients. HO around the hip joint causes a reduction in the functional ability of patients by generating pain and limiting range of motion (ROM). In addition, it results in impaired mobility, ultimately affecting quality of life and increasing the mortality of patients. Extracorporeal shock wave therapy (ESWT) has demonstrated efficacy in treating soft tissue inflammation and has been used to reduce patients' pain in HO. However, almost none of the studies reported degradation in the size of HO on images obtained before and after ESWT application.Patient Concerns And DiagnosisWe report a case of a 36-year-old man who developed HO around both hip joints 3 months after bilateral pontine hemorrhage.InterventionsSeven months after HO development, ESWT was administered to the area of HO every other day for a total of 10 sessions.OutcomesImmediately following treatment, the ROM of both hip joints increased. Thus the patient was able to maintain a sitting posture without having to be bound to the wheelchair. In addition, the tolerable sitting time before groaning increased from less than ten minutes to almost 60 minutes by the end of all ESWT sessions. Unlike other previous reports, a diminished HO size was confirmed by comparing plain X-rays and bone scans obtained before and after treatment sessions.LessonsIn this case, we report an objective size reduction in HO in radiologic findings after applying ESWT to both hips. ESWT is a safe, easy-to-apply, and noninvasive modality. We would like to emphasize the use of ESWT as a treatment option for HO to decrease the extent of HO, as well as to improve pain, spasticity and function in patients with stroke.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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