51-year-old patient:
* Present with a painful lump in right thigh
* No history of trauma
* MRI requested
What should be the subsequent action to be taken?
What should be the subsequent action to be taken?
– Perform an X-ray to exclude the presence of calcifications
– Confirm that there is no prior history of trauma
The patient had been involved in a car accident five months before the lump was detected
What further actions can we taken to assure an accurate diagnosis?
What further actions can we taken to assure an accurate diagnosis?
Perform a follow-up X-ray in three months
What is the most likely diagnosis?
What is the most likely diagnosis?
Myositis ossificans
It should be distinguished from parosteal osteosarcoma and soft tissue sarcoma
Key imaging characteristics to consider include:
-The zonal phenomenon: Mineralization typically initiates and progresses from the periphery towards the center. The absence of this phenomenon should raise concerns.
-Soft tissue edema is more common around myositis ossificans than around sarcomas. It may show marrow edema, periosteal reaction, and peripheral edema at any stage better expressed
Reference: McCarthy EF et al: Heterotopic ossification: a review. Skeletal Radiol. 34(10):609-19, 2005
Very nice case. Important differential