Structured reporting for your learning if not doing it
It has 3D- 1.0mm T2- for fascial and skin assessment
2D Dixon- for fat atrophy, fibrous assessment
DWI- for increased water content
Perfusion for vascular assessment
Pre- and post contrast with subtractionf or fine delayed assessment.
FINDINGS:
Bone and joint alignment: Normal.
Fluid: None.
Main lesion:
Location: Dorsal forearms and visualized elbow
Skin: Mild to moderate thickening and increased signal of the dorsal forearms skin.
Fascia: Thickening and edema of superficial fascia of the dorsal forearms more than volar forearm.
Subcutaneous fat: Moderate atrophy of the subcutaneous fat of the dorsal forearms.
Muscle fascia: Edema of the fascia overlying and intramuscular fascia.
Muscles: Normal appearance of the forearm.
Diffusion assessment: Increased signal of the subcutaneous tissues dorsally bilaterally ADC of the dorsal right forearm cutaneous and subcutaneous tissues measuring 1.7.
Perfusion assessment: Increased vascularity of the right dorsal more than left forearm with persistent enhancement.
Delayed postcontrast assessment: Increased enhancement of the bilateral forearms, dorsal more than volar, bilaterally with superficial cutaneous, subcutaneous and intramuscular fascial plane enhancement. There is also flexor peritendinous enhancement in the carpal tunnels, left greater than right. Increased vascularity bilaterally, right greater than left.
Incidental findings: None.
IMPRESSION:
- Findings of active morphea with deep intramuscular fascial involvement.
RECOMMENDATIONS: Systemic treatment indicated
