Narayan S, Ahluwalia V Verma, Saharan P Singh, Gupta A Kumar
Department of radiodiagnosis, UPRIMS&R, Saifai, India.
Department of Radiodiagnosis, Sarojini Medical College, Agra, India.
J Orthop Case Rep. 2016 Jul-Aug;6(3):56-58. doi: 10.13107/jocr.2250-0685.506.
Benign musculoskeletal lipomatous lesions are common in both soft tissue and bone. Imaging features of benign lipomatous lesions are often pathognomonic. Ultrasound (US) has been used to examine both soft tissue and bone tumors, allowing targeted CT or MRI examination of the region of interest.
A 46-year-old female presented with a four year history of palpable mass lesion just below the lateral aspect of right elbow with clinical evidence of posterior interosseous nerve compression. X-ray showed the presence of a radiolucency mass in relation to radius. HRUS demonstrated a hyperechoic mass in soft tissue with a focal irregularity in bony cortex of radius. The mass lesion compressed the posterior interosseous nerve.
Although CT and MRI diagnose them accurately, but ultrasound characteristics are also conclusive for extra osseous component. This case highlights the importance of HRUS for evaluation of musculoskeletal tumors and any secondary changes in a readily available cost effective dynamic modality and thus guide for treatment planning accordingly.
良性肌肉骨骼脂肪瘤性病变在软组织和骨骼中都很常见。良性脂肪瘤性病变的影像学特征通常具有诊断意义。超声(US)已被用于检查软组织和骨肿瘤,可对感兴趣区域进行有针对性的CT或MRI检查。
一名46岁女性,右肘外侧下方可触及肿块病变4年,有骨间后神经受压的临床证据。X线显示桡骨处有一透亮肿块。高分辨率超声(HRUS)显示软组织内有一高回声肿块,桡骨骨皮质有局灶性不规则。肿块病变压迫骨间后神经。
虽然CT和MRI能准确诊断,但超声特征对骨外成分也具有决定性意义。本病例突出了HRUS在评估肌肉骨骼肿瘤及任何继发性改变方面的重要性,其作为一种易于获得且经济有效的动态检查方式,可为治疗方案的制定提供指导。