case_images: PMC11824486_01
case_images: Multiple swellings over the dorsum of the trunk and bilateral hallux valgus.
case_images: CRIOR2025-2161762.001.jpg
case_images: PMC11824486_01_CRIOR2025-2161762.001.jpg
case_images: fig1
case_images: There is also bilateral valgus deviation of the great toes, as illustrated in Figure 1.
case_images: Inability to elevate the left arm above his shoulders. The picture also shows the patient having difficulty with squatting.
case_images: CRIOR2025-2161762.002.jpg
case_images: PMC11824486_01_CRIOR2025-2161762.002.jpg
case_images: fig2
case_images: Neck and hip range of motion as well as overhead arm elevation is restricted, as shown in Figure 2.
case_images: Knee x-ray shows a pedunculated bony outgrowth from the medial side of the right proximal tibia. Foot AP x-ray shows bilateral hallux valgus with macrodactyly.
case_images: CRIOR2025-2161762.003.jpg
case_images: PMC11824486_01_CRIOR2025-2161762.003.jpg
case_images: fig3
case_images: Figure 3). Foot radiographs show bilateral hallux valgus with a hallux valgus angle of 50  and a first intermetatarsal angle of 12  on both feet (see Figure 3).
case_images: Whole-body CT shows sheets of extraskeletal ossification along the prevertebral soft tissue from the occiput to the sacrum. There are also bony bridges from the ribs to the respective humeri.
case_images: CRIOR2025-2161762.004.jpg
case_images: PMC11824486_01_CRIOR2025-2161762.004.jpg
case_images: fig4
case_images: Whole-body CT (see Figure 4) shows midline long-segment extensive ossification of the posterior paravertebral soft tissue with vertical bony bridges spanning from the occipital protuberance to L4 vertebrae.
case_images: PMC11824486_02
case_images: Multiple lumps visible over the back. Restriction of forward flexion of the trunk also noted.
case_images: CRIOR2025-2161762.005.jpg
case_images: PMC11824486_02_CRIOR2025-2161762.005.jpg
case_images: fig5
case_images: On exam, she has multiple firm, nontender swellings all over the body, as depicted in Figure 5.
case_images: Bilateral hallux valgus and fixed flexion deformity of the left elbow.
case_images: CRIOR2025-2161762.006.jpg
case_images: PMC11824486_02_CRIOR2025-2161762.006.jpg
case_images: fig6
case_images: She also has bilateral hallux valgus, lateral deviation of the trunk, restricted neck range of motion, and fixed flexion deformity of the left elbow, as illustrated in Figure 6.
case_images: Pelvis AP x-ray shows bilateral short broad femoral necks. Knee x-ray shows bony outgrowth from the right distal femur and proximal tibia.
case_images: CRIOR2025-2161762.007.jpg
case_images: PMC11824486_02_CRIOR2025-2161762.007.jpg
case_images: fig7
case_images: The hip radiograph shows bilateral short and broad femoral necks (refer to Figure 7). Figure 7). Foot radiographs show bilateral hallux valgus with wedge-shaped proximal phalanges (see Figure 8).  Figure 9 illustrates the ossification of the posterior paracervical soft tissue along with bridging ossification that connects the upper extremities to the axial spine.
case_images: Foot AP x-ray shows bilateral hallux valgus with wedging of the first proximal phalanges.
case_images: CRIOR2025-2161762.008.jpg
case_images: PMC11824486_02_CRIOR2025-2161762.008.jpg
case_images: fig8
case_images: Figure 7). Foot radiographs show bilateral hallux valgus with wedge-shaped proximal phalanges (see Figure 8).  Figure 9 illustrates the ossification of the posterior paracervical soft tissue along with bridging ossification that connects the upper extremities to the axial spine.
case_images: Lateral cervical x-ray shows band-like ossification over the posterior paracervical soft tissue. Chest x-ray shows bony bridges connecting the right and left humeri with the axial skeleton.
case_images: CRIOR2025-2161762.009.jpg
case_images: PMC11824486_02_CRIOR2025-2161762.009.jpg
case_images: fig9
case_images: Figure 7). Foot radiographs show bilateral hallux valgus with wedge-shaped proximal phalanges (see Figure 8).  Figure 9 illustrates the ossification of the posterior paracervical soft tissue along with bridging ossification that connects the upper extremities to the axial spine.
case_images: Whole-body CT shows ossification of the posterior paravertebral soft tissue, and thoracic kyphosis is depicted.
case_images: CRIOR2025-2161762.010.jpg
case_images: PMC11824486_02_CRIOR2025-2161762.010.jpg
case_images: fig10
case_images: Extensive ossifications are also present around the shoulder and arm bilaterally (see Figure 10).