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Musculoskeletal system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Superficial soft tissue masses can be assessed by ultrasound. Lipoma is one of the commonest superficial masses and a clinical impression can be confirmed provided there are no ‘red flag’ features such as recent onset of pain or rapid enlargement, as a potential diagnosis of liposarcoma should be assessed by MRI. Deep-seated lipoma may require the greater depth resolution of MRI for complete evaluation, particularly in planning a surgical approach. Ganglia and other cysts are also amenable to rapid characterisation by ultrasound, and it may be useful in a range of pathologies including haemangioma, lymphangioma, neuroma and plantar fibroma. Ultrasound is a quick and simple test for intermetatarsal neuroma (Morton’s neuroma) and if positive can be used to proceed directly to treatment by ultrasound-guided steroid injection.
Benign Neck Disease
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Ricard Simo, Jean-Pierre Jeannon, Enyinnaya Ofo
Lipomas have characteristic appearances on USS, and do not require FNAC, unless risk of malignant transformation is suspected. For large lipomas, CT and MRI scanning may be useful in assessing the anatomy and aid surgical planning.53
Lumps and bumps
Published in Michael Gaunt, Tjun Tang, Stewart Walsh, General Surgery Outpatient Decisions, 2018
A lipoma is a soft benign tumour of adipose tissue. Lipomas usually occur singly, but may be multiple. They are commonly subcutaneous, but can be intramuscular. Lipomas are normally painless. If the tumour is tender, then it is more likely to be an angiolipoma. Rarely, liposarcomatous change can occur in a benign lipoma. There is a higher index of suspicion for malignant change if the lesion is large, rapidly growing or painful.
Elastofibroma presented as shoulder pain in an amateur swimmer: screening for referral in physiotherapy. A case report
Published in Physiotherapy Theory and Practice, 2022
Fabrizio Brindisino, Firas Mourad, Filippo Maselli
EF is a mass without a capsule and with uncertain boundaries that cannot be easily distinguished by ultrasound from muscles and the fat that surrounds it. Therefore, specific clinical features, including subscapular location and patient sex and age at the time of the clinical presentation, as well as typical imaging findings on scans (e.g. entrapped fat within a well-defined fibrous mass) are useful to confirm a suspected EF tumor with a high degree of confidence (Bartocci et al., 2017). However, in some cases, biopsy should be recommended. When imaging findings are atypical or in the case of fast-growing lesions, systemic symptoms or atypical location, lipoma, fibrosarcoma, liposarcoma, metastases, neurofibromas, malignant fibrous histiocytoma, hemangioma, soft-tissue sarcoma should be kept in mind for differential diagnosis because many other tumors can be misdiagnosed as EF (Bartocci et al., 2017; Kara, Dikmen, Kara, and Atasoy, 2002; Tamimi Mariño et al., 2013).
Spine duplication or split notochord syndrome – case report and literature review
Published in The Journal of Spinal Cord Medicine, 2020
Barbara Jasiewicz, Magdalena Stachura, Tomasz Potaczek, Slawomir Duda, Piotr Michno, Stanislaw Kwiatkowski
A male neonate weighing 2800 g was delivered at term by caesarian section. Apgar score was 1 at 1 min. His parents were unrelated, and the maternal history was uneventful. Physical examination showed defects of the abdominal wall in the underbelly, cloacal exstrophy with visible urether outlets. The penis and the scrotum were transposed to the right. A narrow fistula or transposed anus, with stool passing through it, was present in the perineal region. Further investigation revealed a normal left kidney and ectopis right . At the back, split bony elements of the spine with nonpalpable sacral bone were noted. A soft, skin-covered lump, with the consistency of a lipoma, was present in the sacral area. There was asymmetry of the lower limbs: the right lower limb had a normal shape and range of motion of the joints, whereas the left lower limb was hypoplastic, with a deformed foot and limited active and passive motions (flaccid paresis from the level of L4). Beginning at the first month of life, the patient underwent several surgeries because of urogenital and gastrointestinal defects.
Congenital Spinal Lipomatous Malformations. Part 1. Spinal Lipomas, Lipomyeloceles, and Lipomyelomeningoceles
Published in Fetal and Pediatric Pathology, 2020
Rare cervicothoracic intramedullary lipomas, which are congenital malformations of mature adipose tissue rostral to the lumbar spinal cord, can pose both severe neurological deficits and surgical challenges. Symptoms usually appear in the third decade, although these lipomas have been seen in children [137]. An embryologic origin has yet to be well characterized but there is no heterogeneous histopathologic component [138–143]. These subpial spinal cord lipomas appear to be part of midline encephalocraniocutaneous lipomatosis that includes corpus callosum lipomas [144, 145]. Most but not all cases have spinal dysraphism [146, 147]. Subcutaneous cervicothoracic lipomas that may accompany cervicothoracic intramedullary lipomas are more likely to be developmental than neoplastic. One symptomatic cervicothoracic intramedullary lipoma was identified concomitantly with a symptomatic conus medullaris lipoma [148]. Older surgical-radiological classifications do not always distinguish between cervicothoracic intramedullary lipomas and congenital lumbosacrococcygeal lipomatous malformations [4, 21].