Quadriceps Myositis Ossificans

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Quadriceps Myositis Ossificans

Authors, Editors, Case Information Author: Charis Hoppe, BSc Affiliation: University of California, San Francisco (UCSF) Co Author(s): William Berrigan, MD Senior Editor: Laura Mattson, DO Clinical Vignette: A 16-year-old male high school football athlete presented after right thigh injury sustained during football practice 2 weeks prior with continued anterior thigh pain with ambulation, knee flexion, and with a decreased range of motion. Type of Probe Used: Linear GE S8 ML6-15 Unlabeled Long Axis View of the Right Quadriceps Muscles Unlabeled Long Axis View of the Right Quadriceps Muscles Labeled Long Axis View of the Right Quadriceps Muscles Labeled Long Axis View of the Right Quadriceps Muscles with evidence of echogenic mineralization within the right vastus intermedius muscle measuring approximately 10.22 cm from proximal to distal with small surrounding hypoechoic fluid collection Unlabeled Short Axis Views of the Right Quadriceps Muscles Unlabeled Short Axis Views of the Right Quadriceps Muscles Labeled Short Axis Views of the Right Quadriceps Muscles Labeled Short Axis Views of the Right Quadriceps Muscles with echogenic mineralization within the right vastus intermedius muscle with small surrounding hypoechoic fluid collection. Interpretation Image Interpretation: Echogenic mineralization within the right vastus intermedius muscle measuring approximately 10.22 cm from proximal to distal with small surrounding hypoechoic fluid collection, consistent with myositis ossificans within the vastus intermedius muscle. Teaching Pearl: Myositis ossificans is a benign, self-limited heterotopic ossification process that can follow muscle trauma in athletes, especially in the quadriceps, brachialis, or adductor groups. Ultrasound can show echogenic mineralization with posterior shadowing, often after an earlier contusion or hematoma phase. A clear inciting injury and typical maturation pattern support the diagnosis. Atypical history, rapid growth, persistent unexplained pain, or unusual imaging appearance should prompt further imaging to exclude infection or malignancy. Surgical intervention is often delayed until full lesion ossification and maturation to minimize the chance of recurrence. References: 1. Lacout A, Jarraya M, Marcy PY, Thariat J, Carlier RY. Myositis ossificans imaging: keys to successful diagnosis. Indian J Radiol Imaging. 2012;22(1):35-39. doi:10.4103/0971-3026.95402 2. Tyler P, Saifuddin A. The imaging of myositis ossificans. Semin Musculoskelet Radiol. 2010;14(2):201-216. doi:10.1055/s-0030-1253161 3. Savvidou O, Papakonstantinou O, Lakiotaki E, Melissaridou D, Korkolopoulou P, Papagelopoulos PJ. Post-traumatic myositis ossificans: a benign lesion that simulates malignant bone and soft tissue tumours. EFORT Open Rev. 2021;6(7):572-583. doi:10.1302/2058-5241.6.210002
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Authors, Editors, Case Information

Unlabeled Long Axis View of the Right Quadriceps Muscles

Labeled Long Axis View of the Right Quadriceps Muscles

Unlabeled Short Axis Views of the Right Quadriceps Muscles

Labeled Short Axis Views of the Right Quadriceps Muscles

Interpretation

UPCOMING EVENTS

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