Finally snow is melting in Dallas.
FINDINGS:
Markers have been placed at the site of concern.
Size: 23 x 13 x 37 mm.
Location: Dorsal ulnar sided forearm subcutaneous tissues with lobulated margins and mild mass effect on the extensive carpi ulnaris (ECU) muscle. Adjacent few small vessels.
Characteristics:
Matrix: T1 isointense and T2 mixed hyperintense signal characteristics.
Uniformity: Heterogenous.
Fluid-fluid levels: No.
Transition zone: Narrow-edema absent.
Periosteal reaction: None.
Chemical shift (Dixon) imaging: Minimal increased signal on the opposed phase imaging compared to the in-phase imaging, probably related to hemosiderin effects.
Diffusion imaging: Hyperintense. ADC measures: 1.5.
Perfusion imaging: Prominent vascular supply from the ulnar artery with associated AV shunting and small aneurysms. Adjoining prominent vessels and early and persistent diffuse perfusion abnormality of ECU muscle.
Delayed post-contrast imaging: Mild peripheral and thin septal internal enhancement.. Patchy delayed enhancement of the ECU muscle.
Extent:
Compartment: Intracompartmental.
Bone involvement: No.
Intra-articular involvement: No.
Neural involvement: No.
Nodal involvement: No.
Incidental findings: High-grade partial tear of the common extensor tendon origin. Small elbow effusion. Subcutaneous edema of the dorsal ulnar forearm. Small wrist effusion
IMPRESSION:
1. Findings suggesting prior vascular malformation related mass lesion, stable since prior exam
2. Findings of the lateral epicondylitis.
3. Small elbow and wrist effusions.
RECOMMENDATIONS: ST-RADS: III. Probably benign soft tissue tumor. Recommend surveillance imaging at 3, 6, 12, and 24 months. If the lesion regresses or resolves, surveillance can be terminated if felt clinically appropriate.
Best!
AC
Avneesh Chhabra, M.D. M.B.A.
Professor, Radiology & Orthopedic Surgery
Chief, Musculoskeletal Radiology
Department of Radiology
5323 Harry Hines, Blvd. Dallas, Tx-75390-9316
Office: 214-648-2122
