EURORAD ESR

Case 11707

Anomalous intraosseous venous drainage

Author(s)
Simões, André; Araújo, Bruno; Viamonte, Bárbara

Centro Hospitalar de São João,
Porto - Portugal
 
Patient
male, 59 year(s)
 
 
  • Figure 1
    Conventional Radiography - Lateral View

    Lateral radiography (a) and an amplified interest region (b) showing an anterior cortical defect (arrow). Two grooves are seen connecting with a central ill-defined sclerotic region (*) Note a small pre-tibial soft...

     
    Area of Interest: Cardiovascular system; Extremities; Vascular; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Varices;
     
     
  • Figure 2
    Conventional Radiography - Frontal View

    Frontal radiography (a) and an amplified interest region (b) showing a lateral cortical defect (arrow) in the middle third of the tibial diaphysis proximal to the anterior cortical defect shown is Fig.1.

     
    Area of Interest: Cardiovascular system; Extremities; Vascular; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Varices;
     
     
  • Figure 3
    MRI - Sagittal STIR images

    A hyperintense tubular structure (arrowhead) is seen perforating the anterior cortex of the tibia (a) crossing the medullary canal (b) and exiting through the nutrient canal (open arrow) (c). Note the pretibial...

     
    Area of Interest: Cardiovascular system; Extremities; Vascular; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Varices;
     
     
  • Figure 4
    MRI - Sagittal T2-weighted images

    Images (a and b) showing the anterior (arrow) and lateral (open arrow) cortical defects. Both connect a central hypointense area corresponding to the sclerotic region seen on radiography images, through small grooves...

     
    Area of Interest: Cardiovascular system; Extremities; Vascular; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Varices;
     
     
  • Figure 5
    Axial T2-weighted images

    Images (a - h) showing the same structures as in Fig. 4. Anterior (arrow) and lateral (open arrow) cortical defects. The vascular structure arises from pretibial varices (*) and drains in the deep venous drainage...

     
    Area of Interest: Cardiovascular system; Extremities; Vascular; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Varices;
     
     
  • Figure 6
    MRI - Axial T1-weighted images

    Images (a - h) showing the same structures as in Fig. 5. Anterior (arrow) and lateral (open arrow) cortical defects, central hypointense area and connecting grooves.

     
    Area of Interest: Cardiovascular system; Extremities; Vascular; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Varices;
     
     
  • Figure 7
    MRI - Axial T1-weighted images with fat-sat (contrast enhanced)

    Images (a - h) showing the same structures as in Fig. 6. Anterior (arrow) and lateral (open arrow) cortical defects. The vascular structure arises from pretibial varices (*) and drains in the deep venous drainage...

     
    Area of Interest: Cardiovascular system; Extremities; Vascular; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Varices;
     
     
  • Figure 8
    MRI - Sagittal T1-weighted images with fat-sat (contrast enhanced)

    Images (a – c) showing the anterior (arrow) and lateral (open arrow) cortical defects. Note the marked enhancement of the vascular structure crossing the medullary canal. Pretibial varices are clearly depicted (*).

     
    Area of Interest: Cardiovascular system; Extremities; Vascular; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Varices;
     
     
Lateral radiography (a) and an amplified interest region (b) showing an anterior cortical defect (arrow). Two grooves are seen connecting with a central ill-defined sclerotic region (*) Note a small pre-tibial soft tissue mass (arrowhead).
 
Frontal radiography (a) and an amplified interest region (b) showing a lateral cortical defect (arrow) in the middle third of the tibial diaphysis proximal to the anterior cortical defect shown is Fig.1.
 
A hyperintense tubular structure (arrowhead) is seen perforating the anterior cortex of the tibia (a) crossing the medullary canal (b) and exiting through the nutrient canal (open arrow) (c). Note the pretibial varices (arrow).
 
Images (a and b) showing the anterior (arrow) and lateral (open arrow) cortical defects. Both connect a central hypointense area corresponding to the sclerotic region seen on radiography images, through small grooves (arrowheads).
 
Images (a - h) showing the same structures as in Fig. 4. Anterior (arrow) and lateral (open arrow) cortical defects. The vascular structure arises from pretibial varices (*) and drains in the deep venous drainage (arrowhead).
 
Images (a - h) showing the same structures as in Fig. 5. Anterior (arrow) and lateral (open arrow) cortical defects, central hypointense area and connecting grooves.
 
Images (a - h) showing the same structures as in Fig. 6. Anterior (arrow) and lateral (open arrow) cortical defects. The vascular structure arises from pretibial varices (*) and drains in the deep venous drainage (arrowhead).
 
Images (a – c) showing the anterior (arrow) and lateral (open arrow) cortical defects. Note the marked enhancement of the vascular structure crossing the medullary canal. Pretibial varices are clearly depicted (*).
 
 
 
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