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Tendon Xanthomas in Familial Hypercholesterolemia

Shogan PJS - MedPix (2008)

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Tendon Xanthomas in Familial Hypercholesterolemia

History: 51 yo male with soft-tissue ankle mass.

Findings: AP and lateral radiographs of the right ankle, reveal a soft-tissue mass without internal calcifications overlying the lateral malleolus. Additionally, there is fusiform thickening of the Achilles Tendon. MRI of the Right Ankle: There is a multilobulated mass, measuring 2.6 x 2.5 x 1.4 cm at the anterior aspect of the fibula, that is isointense on T1, hypointense on T2, and isointense to the Achilles tendon on T2 weighted sequences. There is no associated bony erosion. Additionally, there is marked thickening of the Achilles tendon without hyperintense signal to suggest tear. Also noted is convex curvature to the normally flat or concave anterior aspect of Achilles tendon. MRI of the Left Ankle: There is marked thickening of the Achilles tendon without hyperintense signal to suggest tear. Also noted is convex curvature to the normally flat or concave anterior aspect of Achilles tendon. Thickening of the tendinous portion of the medial plantar fascia is also noted.

Ddx: Achilles Tendonitis Partial Achilles tendon tear Gout Neoplasms of the Achilles tendon. Achilles’-Tendon Xanthoma

Dxhow: Findings of bilateral symmetric diffuse thickening of the Achilles tendon without abnormal T2 signal, coupled with a similar focal mass with similar signal characteristics to the Achilles tendons, located adjacent to the right fibula, strongly suggests these are xanthomas related to familial hypercholesterolemia.

No MeSH data available.


Sagittal FSE FS T2 weighted image of the left ankle reveals abnormal thickening of the Achilles tendon, without abnormal hyperintense signal to suggest a tear.  Also noted is convex curvature to the normally flat or concave anterior aspect of Achilles tendon.
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MPX2193_synpic42196: Sagittal FSE FS T2 weighted image of the left ankle reveals abnormal thickening of the Achilles tendon, without abnormal hyperintense signal to suggest a tear. Also noted is convex curvature to the normally flat or concave anterior aspect of Achilles tendon.


Tendon Xanthomas in Familial Hypercholesterolemia

Shogan PJS - MedPix (2008)

Sagittal FSE FS T2 weighted image of the left ankle reveals abnormal thickening of the Achilles tendon, without abnormal hyperintense signal to suggest a tear.  Also noted is convex curvature to the normally flat or concave anterior aspect of Achilles tendon.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX2193&req=5

MPX2193_synpic42196: Sagittal FSE FS T2 weighted image of the left ankle reveals abnormal thickening of the Achilles tendon, without abnormal hyperintense signal to suggest a tear. Also noted is convex curvature to the normally flat or concave anterior aspect of Achilles tendon.

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: Tendon Xanthomas in Familial Hypercholesterolemia

History: 51 yo male with soft-tissue ankle mass.

Findings: AP and lateral radiographs of the right ankle, reveal a soft-tissue mass without internal calcifications overlying the lateral malleolus. Additionally, there is fusiform thickening of the Achilles Tendon. MRI of the Right Ankle: There is a multilobulated mass, measuring 2.6 x 2.5 x 1.4 cm at the anterior aspect of the fibula, that is isointense on T1, hypointense on T2, and isointense to the Achilles tendon on T2 weighted sequences. There is no associated bony erosion. Additionally, there is marked thickening of the Achilles tendon without hyperintense signal to suggest tear. Also noted is convex curvature to the normally flat or concave anterior aspect of Achilles tendon. MRI of the Left Ankle: There is marked thickening of the Achilles tendon without hyperintense signal to suggest tear. Also noted is convex curvature to the normally flat or concave anterior aspect of Achilles tendon. Thickening of the tendinous portion of the medial plantar fascia is also noted.

Ddx: Achilles Tendonitis Partial Achilles tendon tear Gout Neoplasms of the Achilles tendon. Achilles’-Tendon Xanthoma

Dxhow: Findings of bilateral symmetric diffuse thickening of the Achilles tendon without abnormal T2 signal, coupled with a similar focal mass with similar signal characteristics to the Achilles tendons, located adjacent to the right fibula, strongly suggests these are xanthomas related to familial hypercholesterolemia.

No MeSH data available.