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Myositis Ossificans
Arthur B. Meyers, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Diagnostic Checklist

          TERMINOLOGY

          • Synonyms

            • Heterotopic ossification (HO), myositis ossificans circumscripta
            • Others: Myositis ossificans traumatica, pseudomalignant myositis ossificans, pseudomalignant osseous tumor of soft tissue, extraosseous localized nonneoplastic bone & cartilage formation
          • Definitions

            • Myositis ossificans (MO): Benign ossifying soft tissue mass; reactive lesion typically occurring after muscle insult
              • Clear history of trauma in 60-75% of cases
              • Others: Repetitive microtrauma, inflammation, ischemia
            • Exact etiology unclear but not due to primary muscle inflammation (myositis = misnomer)
            • HO: More general term for bone formation in extraskeletal location
              • HO term more commonly used in patients after CNS injuries or surgery

          IMAGING

          • General Features

            • Radiographic Findings

              • Ultrasonographic Findings

                • CT Findings

                  • MR Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Natural History & Prognosis

                                  • Treatment

                                    DIAGNOSTIC CHECKLIST

                                    • Consider

                                      • Image Interpretation Pearls

                                        Selected References

                                        1. Walczak BE et al: Myositis ossificans. J Am Acad Orthop Surg. 23(10):612-22, 2015
                                        2. Kransdorf MJ et al: Extraskeletal Osseous and Cartilage Lesions. In Kransdorf MJ et al: Imaging of Soft Tissue Tumors. 3rd ed. Philadelphia: Lippincott, Williams & Wilkins. 541-589, 2014
                                        3. Seipel R et al: Neurogenic heterotopic ossification: epidemiology and morphology on conventional radiographs in an early neurological rehabilitation population. Skeletal Radiol. 41(1):61-6, 2012
                                        4. Tyler P et al: The imaging of myositis ossificans. Semin Musculoskelet Radiol. 14(2):201-16, 2010
                                        5. Laffan EE et al: Pediatric soft-tissue tumors and pseudotumors: MR imaging features with pathologic correlation: part 2. Tumors of fibroblastic/myofibroblastic, so-called fibrohistiocytic, muscular, lymphomatous, neurogenic, hair matrix, and uncertain origin. Radiographics. 29(4):e36, 2009
                                        6. Parikh J et al: The imaging features of post-traumatic myositis ossificans, with emphasis on MRI. Clin Radiol. 57(12):1058-66, 2002
                                        7. Kransdorf MJ et al: Myositis ossificans: MR appearance with radiologic-pathologic correlation. AJR Am J Roentgenol. 157(6):1243-8, 1991
                                        8. Thomas EA et al: The role of ultrasound in the early diagnosis and management of heterotopic bone formation. Clin Radiol. 43(3):190-6, 1991
                                        Related Anatomy
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                                        Related Differential Diagnoses
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                                        References
                                        Tables

                                        Tables

                                        KEY FACTS

                                        • Terminology

                                          • Imaging

                                            • Top Differential Diagnoses

                                              • Diagnostic Checklist

                                                TERMINOLOGY

                                                • Synonyms

                                                  • Heterotopic ossification (HO), myositis ossificans circumscripta
                                                  • Others: Myositis ossificans traumatica, pseudomalignant myositis ossificans, pseudomalignant osseous tumor of soft tissue, extraosseous localized nonneoplastic bone & cartilage formation
                                                • Definitions

                                                  • Myositis ossificans (MO): Benign ossifying soft tissue mass; reactive lesion typically occurring after muscle insult
                                                    • Clear history of trauma in 60-75% of cases
                                                    • Others: Repetitive microtrauma, inflammation, ischemia
                                                  • Exact etiology unclear but not due to primary muscle inflammation (myositis = misnomer)
                                                  • HO: More general term for bone formation in extraskeletal location
                                                    • HO term more commonly used in patients after CNS injuries or surgery

                                                IMAGING

                                                • General Features

                                                  • Radiographic Findings

                                                    • Ultrasonographic Findings

                                                      • CT Findings

                                                        • MR Findings

                                                          • Nuclear Medicine Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • Gross Pathologic & Surgical Features

                                                                  • Microscopic Features

                                                                    CLINICAL ISSUES

                                                                    • Presentation

                                                                      • Natural History & Prognosis

                                                                        • Treatment

                                                                          DIAGNOSTIC CHECKLIST

                                                                          • Consider

                                                                            • Image Interpretation Pearls

                                                                              Selected References

                                                                              1. Walczak BE et al: Myositis ossificans. J Am Acad Orthop Surg. 23(10):612-22, 2015
                                                                              2. Kransdorf MJ et al: Extraskeletal Osseous and Cartilage Lesions. In Kransdorf MJ et al: Imaging of Soft Tissue Tumors. 3rd ed. Philadelphia: Lippincott, Williams & Wilkins. 541-589, 2014
                                                                              3. Seipel R et al: Neurogenic heterotopic ossification: epidemiology and morphology on conventional radiographs in an early neurological rehabilitation population. Skeletal Radiol. 41(1):61-6, 2012
                                                                              4. Tyler P et al: The imaging of myositis ossificans. Semin Musculoskelet Radiol. 14(2):201-16, 2010
                                                                              5. Laffan EE et al: Pediatric soft-tissue tumors and pseudotumors: MR imaging features with pathologic correlation: part 2. Tumors of fibroblastic/myofibroblastic, so-called fibrohistiocytic, muscular, lymphomatous, neurogenic, hair matrix, and uncertain origin. Radiographics. 29(4):e36, 2009
                                                                              6. Parikh J et al: The imaging features of post-traumatic myositis ossificans, with emphasis on MRI. Clin Radiol. 57(12):1058-66, 2002
                                                                              7. Kransdorf MJ et al: Myositis ossificans: MR appearance with radiologic-pathologic correlation. AJR Am J Roentgenol. 157(6):1243-8, 1991
                                                                              8. Thomas EA et al: The role of ultrasound in the early diagnosis and management of heterotopic bone formation. Clin Radiol. 43(3):190-6, 1991