International Journal of Anatomy, Radiology and Surgery, 2015 Jul, Vol-4(3): 37-39 37 ID: IJARS/2015/4478:2061 Case Report Keywords: Big toes, Calcifications; ‘Munchmeyer’s disease’, Paraspinal ossification, Synphalangism ABSTRACT Fibrodysplasia ossificans progressiva is one of the rarest and one of the most debilitating and disabling disorders known to affect the mankind. Short big toes and unrestrict- ed progressive ossification of soft tissues, are its hallmarks. Failure of early diagnosis and erroneous interpretation of histology has resulted in patients being mistreated with sur- gical excision and several cycles of radiotherapy. This case report describes a rare case of this bizarre entity which presented to our institute. Typical imaging findings are highlighted that clinch the diagnosis and thus enable one to avoid biopsy which can further hasten this process. Radiology Section Role of Imaging in A Case of Fibrodysplasia Ossificans Progressiva RACHIT HARJAI, SUSHIL. G. KACHEWAR CASE REPORT A 15 years old, presented with multiple swellings over the back which she has been noticing for the past 3 years. The swellings over the back were insidious in onset, progressive in nature, painless. She had a bowed posture as her spinal movements were restricted. There was no history of any significant trauma. Laboratory investigations were essentially normal. On examination, there were multiple, non-tender, hard (bone like) swellings varying in size from 2 cm to over 15 cm. The swellings had indistinct edges and there were no signs of active inflammation. What was unique in this patient was that the great toes of both feet very significantly and symmetrically short. As shown in [Table/Fig-1], clinical photographs revealed multiple swellings over the back. Plain Radiograph of D-L spine showed ossification in bilateral paravertebral soft tissues. [Table/Fig-2]: Ultrasound of the swellings showing hyperechoic foci within it associated with posterior acoustic shadowing suggestive of dense calcification / ossification inside it. A sagittal reformatted CT image better depicts the location and extent of these ossifications Ultrasound of the swellings [Table/Fig-2], showing hyperechoic foci within it associated with posterior acoustic shadowing suggestive of dense calcification / ossification inside it. These were confirmed in CT scan images. A sagittal reformatted CT image better depicted the location and extent. Clinical photograph showed short great toes of both feet [Table/Fig-3] and Plain Radiograph of both feet [Table/Fig-4] [Table/Fig-1]: Clinical photograph showing multiple swellings over the back. Plain Radiograph of D-L spine showing ossification in bi- lateral paravertebral soft tissues