US Area of Interest With IV Contrast The diagnostic accuracy of US is considerably less when lesions outside the subcutaneous tissue are included. It is also less reliable for defining deep masses in large anatomical areas [27]. Although an assessment of diagnostic accuracy of US with IV contrast in the setting of a deep soft tissue mass is not available in the current literature, there is presumably no added benefit over standard grayscale and Doppler US. Therefore, the US with IV contrast is not useful for the initial assessment of deep soft tissue masses. MRI Area of Interest Without and With IV Contrast The current radiology, orthopedic oncology, and surgical oncology literature does not support the use of MRI without and with IV as the initial examination for a soft tissue mass. MRI Area of Interest Without IV Contrast The current radiology, orthopedic oncology, and surgical oncology literature does not support the use of MRI without IV contrast as the initial examination for a soft tissue mass. Soft Tissue Masses CT Area of Interest With IV Contrast CT with IV contrast does not typically play a role in the initial evaluation of a deep soft tissue mass. However, CT can be useful in areas where the osseous anatomy is complex or obscured for the distinction of ossification from calcification and the identification of characteristic patterns of mineralization [29,30]. In anatomically complex areas where radiographs would be less sensitive, CT may be beneficial as the initial or complementary imaging modality. Fortunately, the advent of virtual noncontrast reconstruction with modern dual-source CT scanners allows for acquisition of a single postcontrast scan with reconstruction of virtual noncontrast images, which can preclude the need for a separate precontrast scan phase [31]. For myositis ossificans, CT is superior to radiography in detecting the zonal pattern of mineralization, which is essential for early diagnosis [11].
Soft Tissue Masses. US Area of Interest With IV Contrast The diagnostic accuracy of US is considerably less when lesions outside the subcutaneous tissue are included. It is also less reliable for defining deep masses in large anatomical areas [27]. Although an assessment of diagnostic accuracy of US with IV contrast in the setting of a deep soft tissue mass is not available in the current literature, there is presumably no added benefit over standard grayscale and Doppler US. Therefore, the US with IV contrast is not useful for the initial assessment of deep soft tissue masses. MRI Area of Interest Without and With IV Contrast The current radiology, orthopedic oncology, and surgical oncology literature does not support the use of MRI without and with IV as the initial examination for a soft tissue mass. MRI Area of Interest Without IV Contrast The current radiology, orthopedic oncology, and surgical oncology literature does not support the use of MRI without IV contrast as the initial examination for a soft tissue mass. Soft Tissue Masses CT Area of Interest With IV Contrast CT with IV contrast does not typically play a role in the initial evaluation of a deep soft tissue mass. However, CT can be useful in areas where the osseous anatomy is complex or obscured for the distinction of ossification from calcification and the identification of characteristic patterns of mineralization [29,30]. In anatomically complex areas where radiographs would be less sensitive, CT may be beneficial as the initial or complementary imaging modality. Fortunately, the advent of virtual noncontrast reconstruction with modern dual-source CT scanners allows for acquisition of a single postcontrast scan with reconstruction of virtual noncontrast images, which can preclude the need for a separate precontrast scan phase [31]. For myositis ossificans, CT is superior to radiography in detecting the zonal pattern of mineralization, which is essential for early diagnosis [11].