Name of the Patient : Abc Xyza Furlmn / F / 5 yrs.
Referred by : Dr. Abc Xyzouza.
Examination : M.R.I. of the Right Thigh.
CLINICAL PROFILE :
H/O excision of a hematoma from the right lower one-third thigh on 00.00.00.
M.R.I. of the right thigh was performed using the following parameters :
10 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.
7 mm thick STIR and T1 Weighted coronal images.
7 mm thick T1 Weighted and T2 Weighed sagittal images.
There is a large lobulated mass lesion in the anterior aspect of the right thigh in the fat plane between the vastus medialis and the lateralis muscles. This lesion is slightly hyperintense to normal muscle on the T1 Weighted images and turns intensely hyperintense on the T2 Weighted and STIR images. Few hyperintense areas are seen within these muscles on the T1 Weighted images and which are slightly hypointense on the T2 Weighted images and may represent altered blood. The vastus lateralis muscle is displaced laterally and compressing upon the vastus intermedius muscle. This lesion is also seen to extend anteriorly into the subcutaneous fat in the lower one third of the thigh with a break in the subcutaneous tissue probably due to previous surgery. Subtle hyperintense signal is seen along the fat plane in the upper thigh between the anterior and the posterior compartment extending into the pelvis lateral to the adductor and pectineus muscles.
A similar signal intensity lesion which is large, rounded is seen lateral to the right lateral aspect of the bladder and compressing upon the same. Anteriorly this lesion is seen to be incontinuity with the subcutaneous region in the pelvis on the right side (se/im:110/3, 4 and 104/10). This lesion is separate from the right iliopsoas muscle. This lesion is seen to extend upto the L5 vertebral level.
The visualized blood vessels in the right thigh are slightly prominent as compared to the left side.
The visualized portion of the right femur shows normal signal intensity. There is no obvious bony destruction or erosion.
In a known C/O hematoma the MRI features are suggestive of a lesion in the lower half of the right thigh with a lesion in the pelvis along the fat planes anteriorly.
This lesion is not specific for a single diagnosis. This may represent a neoplastic process like a hemangioma or soft tissue sarcoma. An infective process though less likely cannot be entirely excluded.