She took steroids and says the lump has diminished in size.
This US is to evaluate the lump.
I have no experience imaging Morphea…didn’t know we did that, or that it
is treated with steroids (do you???)
[image: 1.jpg]
The lump is in the affected area…there is striking echogenicity of the
subcutaneous fat; the lump is the elongated hyphoechoic area at the
interface between the quad fascia and deep subcutaneous fat
[image: 2.jpg]
It is non-compressible….I don’t know if it’s a chronic, complex
collection or non-specific inflammation. No hx of trauma, by the way.
[image: 3.jpg]
Is there any reason to recommend MRI?
Is there any reason to follow up with US?
Thanks.
Hilary
1 thought on “Please Help…Thigh Ultrasound in 50F with Morphea Flare March with lump”
avneesh.chhabra
Yes- MRI is better
Done for deeper and longitudinal extent
In our study, there was 5cm above and below extension of lesion on MRI as compared to clinically measured extent
Will send a case later- doing a procedure
citation
Abbas LF, O’Brien JC, Goldman S, Pezeshk P, Chalian M, Chhabra A, Jacobe HT. A Cross-sectional Comparison of Magnetic Resonance Imaging Findings and Clinical Assessment in Patients With Morphea. JAMA Dermatol. 2020 May 1;156(5):590-592. doi: 10.1001/jamadermatol.2020.0036. PMID: 32236514; PMCID: PMC7113827.
On us- look for skin/subq edema/thickening/ fat hypertrophy and atrophy/incr doppler flow
On MRI-apart from above- total extent, muscle and deep fascial invol/ high perfusion/diffusion in fat/enhancement/ muscle invol- f/up on treatment / d/d from other related disorders- cellulitis/myositis/denervation/myonecrosis/eosinophilic fascitis
T/t with steroids/methotrexate and other immunomodulators
We also do multiparametric MRI pre- and postop for response to t/t
She took steroids and says the lump has diminished in size.
This US is to evaluate the lump.
I have no experience imaging Morphea…didn’t know we did that, or that it is treated with steroids (do you???)
[1.jpg]
The lump is in the affected area…there is striking echogenicity of the subcutaneous fat; the lump is the elongated hyphoechoic area at the interface between the quad fascia and deep subcutaneous fat
[2.jpg]
It is non-compressible….I don’t know if it’s a chronic, complex collection or non-specific inflammation. No hx of trauma, by the way.
[3.jpg]
Is there any reason to recommend MRI?
Is there any reason to follow up with US?
Done for deeper and longitudinal extent
In our study, there was 5cm above and below extension of lesion on MRI as compared to clinically measured extent
Will send a case later- doing a procedure
citation
Abbas LF, O’Brien JC, Goldman S, Pezeshk P, Chalian M, Chhabra A, Jacobe HT. A Cross-sectional Comparison of Magnetic Resonance Imaging Findings and Clinical Assessment in Patients With Morphea. JAMA Dermatol. 2020 May 1;156(5):590-592. doi: 10.1001/jamadermatol.2020.0036. PMID: 32236514; PMCID: PMC7113827.
On us- look for skin/subq edema/thickening/ fat hypertrophy and atrophy/incr doppler flow
On MRI-apart from above- total extent, muscle and deep fascial invol/ high perfusion/diffusion in fat/enhancement/ muscle invol- f/up on treatment / d/d from other related disorders- cellulitis/myositis/denervation/myonecrosis/eosinophilic fascitis
T/t with steroids/methotrexate and other immunomodulators
We also do multiparametric MRI pre- and postop for response to t/t
Will send later
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
http://www.utsouthwestern.edu/radiology<http://www.utsouthwestern.edu/education/medical-school/departments/radiology/>
EXTERNAL MAIL
She took steroids and says the lump has diminished in size.
This US is to evaluate the lump.
I have no experience imaging Morphea…didn’t know we did that, or that it is treated with steroids (do you???)
[1.jpg]
The lump is in the affected area…there is striking echogenicity of the subcutaneous fat; the lump is the elongated hyphoechoic area at the interface between the quad fascia and deep subcutaneous fat
[2.jpg]
It is non-compressible….I don’t know if it’s a chronic, complex collection or non-specific inflammation. No hx of trauma, by the way.
[3.jpg]
Is there any reason to recommend MRI?
Is there any reason to follow up with US?
Thanks.
Hilary
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