history.
Thought the mass in the adductor looked like hemorrhage and wondered about
myositis ossificans.
To me, I thought the adductor looked stripped off the medial femur, like
thigh splints….suggesting injury.
But now I see he has symptoms x 3 weeks and denies trauma (for what that’s
worth).
[image: 1.jpg]
[image: 2.jpg]
[image: 3.jpg]
I recommended non contrast CT to look for calcification / ossification, but
it was done
post-contrast….no pre-contrast.
[image: 4.jpg]
There is peripheral high attenuation…which I presume is enhancement…I
don’t
think it’s high enough to be calcification—agree?
If it’s only 3 weeks, it might be too early to see calcification.
Centrally it is 30HU.
[image: 5.jpg]
My questions are:
1. Can I be certain this is simply hematoma? Usually we see peripheral
hemosiderin, not just diffuse central dark signal….which threw me.
2. Can this be hemorrhagic tumor?
3. Any point to recalling for non-contrast CT?
4. Any point to MRI w/ and w/o contrast?
5. Should I just recommend f/u MRI or CT (which? when?)
6. Or would you recommend orthopedic oncologic consultation at this point?
Thank you.
Hilary
