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Myositis Ossificans (MO) is a benign, heterotopic (extra-skeletal) ossification process occurring within soft tissues, typically skeletal muscle, following trauma.

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It represents a non-neoplastic, reactive proliferation of bone and cartilage and is characterized radiologically by a classic zonal pattern of ossification.

https://youtu.be/ykhkWmpaN6o

Etiopathogenesis


Pathological Phases

Phase Timeframe Pathology Imaging Findings
Early 0–2 weeks Cellular proliferation, edema Soft tissue swelling, no calcification (US/MRI)
Intermediate 2–4 weeks Osteoid production Ill-defined peripheral calcifications on X-ray
Mature >6 weeks Mature lamellar bone Well-defined peripheral ossification with lucent center

Radiology


https://youtu.be/hBFYkXbO0ik

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Bbenign ossifying soft-tissue mass, emphasizing the zonal maturation pattern and peripheral calcification with central lucency, best seen in CT and plain radiographs

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Modality Imaging features
XR • Peripheral, well-circumscribed calcification.
Zonal phenomenon: Densely ossified rim with radiolucent center (reverse of malignancy).
Separated from adjacent bone (key differentiator from osteosarcoma).
US Early: Heterogeneous mass with increased vascularity.
Late: Hyperechoic rim corresponding to ossified periphery.
CT Best for identifying mature ossification and exact location relative to bone.
• Shows peripheral mineralization, sometimes with a lucent central zone.
MR Early: Soft-tissue mass, high T2 signal, edema; may mimic soft tissue sarcoma.
Late: Peripheral low signal rim on all sequences due to calcification/ossification.

Common locations: