A 56 Y/O man with tense and painful calf

 

Images

Doctor's Information

Name :  Morteza
Family :Sanei Taheri
Email :   This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident :  Samira Shahhamzei

 

Patient's Information

Gender :  Male
Age :  56

 

Case Section

Muskuloskeletal System

 

Clinical Summary

A 56 Y/O man with tense and painful calf

 

 

Imaging Procedures and Findings

Axial T1WI and T2WI MRI demonstrate high signal collection with relatively central low signal in right soleus muscle which is not suppressed in PD fat suppressed images. Number 1 and 2 in figure 4 is anatomy queez!!!

 

Discussion

Hematoma may result from direct trauma associated with contusion or related to myotendinous injury and subsequent bleeding. MRI and ultrasound helps assess size and location and determine if it is intermuscular or intramuscular in nature. Large hematomas may result in compartment syndrome or significant pain and aspiration may be needed. The MR appearance of hematomas can be variable depending on age and magnetic field strength and T1- and T2-weighted images can help determine the age and relative oxidative state of hemoglobin. Acute hematomas are usually isointense to muscle on T1-weighted images. T2-weighted images show increased signal intensity possibly with central decreased signal related to deoxyhemoglobin . Subacute hematomas (>48 hours) have increased amounts of methemoglobin, which has increased T1 signal. Chronic hematomas may have a peripheral dark rim related to hemosiderin. A seroma may ultimately develop with resorption of blood products.

 

Final Diagnosis

Sub acute Hematoma in right soleus muscle Anatomy queez: 1.medial head of gastrocnemius 2.posterior tibial vessel and tibial nerve

 

References

Dr. Blankenbaker , MR Imaging of Muscle Injuries: Muscle Hematoma , 2004 Anderson Publishing,, Applied Radiology. 2004;33(4)

 

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