History and cross-sectional imaging play an important role in identifying subtle lesions that can be missed on plain radiographs. Despite their widespread use as screening tools, radiographs may fail to yield diagnostic findings, and in some situations, may appear normal altogether. Pathologies that share characteristics such as osteolysis, periosteal reaction, and soft tissue extension are often poorly evaluated on plain films, and the chronicity of a condition may confound the evaluation even further. In these situations, an evaluation with a cross-sectional modality, such as MRI, which offers high contrast resolution, and, in pediatric populations, avoids radiation, is recommended.