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Intramuscular hemangioma causing periosteal reaction and cortical hypertrophy misdiagnosed as osteoid osteoma ☆

View Article: PubMed Central - PubMed

ABSTRACT

We report a case of intramuscular hemangioma mimicking osteoid osteoma.

Magnetic resonance image (MRI) is the most precise diagnostic tool for the identification of soft-tissue mass adjacent to the bone.

Precise preoperative diagnosis is essential to avoid excessive surgery.

Precise preoperative diagnosis is essential to avoid excessive surgery.

No MeSH data available.


Related in: MedlinePlus

Axial CT scan revealed a cortically based sclerotic lesion emanating from the posterior aspect of the tibial diaphysis (white arrow). A poorly defined high density heterogeneous mass was seen immediately posterior to the cortically based lesion, within the adjacent musculature, likely representing a phlebolith (red circle).
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fig0010: Axial CT scan revealed a cortically based sclerotic lesion emanating from the posterior aspect of the tibial diaphysis (white arrow). A poorly defined high density heterogeneous mass was seen immediately posterior to the cortically based lesion, within the adjacent musculature, likely representing a phlebolith (red circle).

Mentions: A 41-year-old female presented with a 6-year history of calf pain in her right lower leg. Initial conservative therapy at a local medical doctor that consisted of aspirin or no steroid anti-inflammatory drugs failed to alleviate the patient’s symptoms. The pain progressed to the point of limiting her normal daily activities in the last three months. Although typical night pain was not observed, minimal pressure on the affected area resulted in severe pain that awakens her from sleep. There was no history of prior trauma or infection. The remaining medical history was unremarkable. On physical examination, there was a significant amount of pain elicited with palpation on mid-calf. No local palpable mass, warmth or bruit was noted. There was no obvious skin change overlying the painful area. The range of movements of knee and ankle were full and free. All laboratory studies were normal. Plain radiographs showed the irregular sclerotic periosteal reaction of the posterior mid-diaphyseal cortex of the right tibia. Although the mass lesion was not well visualized on images in the anteroposterior plane, it was well pictured on the lateral projection. There was no associated osseous destruction or fracture, nor were there calcifications adjacent to the mass. Soft tissue abnormalities were not identified within the tibia, and the visualized knee and ankle joints appeared normal (Fig. 1). Axial computed tomography (CT) scans with contrast revealed a cortically based sclerotic lesion that emanated from the posterior aspect of the tibial diaphysis (2.01 cm × 4.79 cm × 0.67 cm in the sagittal, coronal, and axial planes, respectively). There was no identifiable cortical breakthrough (Fig. 2).


Intramuscular hemangioma causing periosteal reaction and cortical hypertrophy misdiagnosed as osteoid osteoma ☆
Axial CT scan revealed a cortically based sclerotic lesion emanating from the posterior aspect of the tibial diaphysis (white arrow). A poorly defined high density heterogeneous mass was seen immediately posterior to the cortically based lesion, within the adjacent musculature, likely representing a phlebolith (red circle).
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5384294&req=5

fig0010: Axial CT scan revealed a cortically based sclerotic lesion emanating from the posterior aspect of the tibial diaphysis (white arrow). A poorly defined high density heterogeneous mass was seen immediately posterior to the cortically based lesion, within the adjacent musculature, likely representing a phlebolith (red circle).
Mentions: A 41-year-old female presented with a 6-year history of calf pain in her right lower leg. Initial conservative therapy at a local medical doctor that consisted of aspirin or no steroid anti-inflammatory drugs failed to alleviate the patient’s symptoms. The pain progressed to the point of limiting her normal daily activities in the last three months. Although typical night pain was not observed, minimal pressure on the affected area resulted in severe pain that awakens her from sleep. There was no history of prior trauma or infection. The remaining medical history was unremarkable. On physical examination, there was a significant amount of pain elicited with palpation on mid-calf. No local palpable mass, warmth or bruit was noted. There was no obvious skin change overlying the painful area. The range of movements of knee and ankle were full and free. All laboratory studies were normal. Plain radiographs showed the irregular sclerotic periosteal reaction of the posterior mid-diaphyseal cortex of the right tibia. Although the mass lesion was not well visualized on images in the anteroposterior plane, it was well pictured on the lateral projection. There was no associated osseous destruction or fracture, nor were there calcifications adjacent to the mass. Soft tissue abnormalities were not identified within the tibia, and the visualized knee and ankle joints appeared normal (Fig. 1). Axial computed tomography (CT) scans with contrast revealed a cortically based sclerotic lesion that emanated from the posterior aspect of the tibial diaphysis (2.01 cm × 4.79 cm × 0.67 cm in the sagittal, coronal, and axial planes, respectively). There was no identifiable cortical breakthrough (Fig. 2).

View Article: PubMed Central - PubMed

ABSTRACT

We report a case of intramuscular hemangioma mimicking osteoid osteoma.

Magnetic resonance image (MRI) is the most precise diagnostic tool for the identification of soft-tissue mass adjacent to the bone.

Precise preoperative diagnosis is essential to avoid excessive surgery.

Precise preoperative diagnosis is essential to avoid excessive surgery.

No MeSH data available.


Related in: MedlinePlus