Venography - right foot view
Cardiovascular
Case TypeClinical Cases
AuthorsCamenzuli A, Klafkowski G, Yeong C, Attard A.
Patient30 years, male
On examination, two small irregular areas of blue/purple discolouration were seen. One of these lesions was present diffusely around the dorsum of the toes and the other over the medial malleolus of the right leg. The foot was warm and there was no oedema. There was no evidence of deep vein thrombosis.
Most venous malformations are symptomatic with swelling and pain. The overlying skin may have a blue or purple discolouration. Venography or doppler ultrasound may confirm the diagnosis, however magnetic resonance imaging (MRI) better defines the extent of the abnormality. On MRI the abnormality is seen as focal or diffuse areas of high signal on T2-weighted images, often containing separate spaces. Diffuse lesions of the lower extremities can cause haemarthrosis and an arthropathy; these are best demonstrated using MR venography (2). Interventional techniques such as intralesional sclerotherapy may play an important role in their management. Treatment with direct injection of absolute ethanol after venography is effective and results in thrombosis and involution(3).
[1] 1. Burrows P.E, Laor T, Palltiel H, Robertson R.L. Diagnostic imaging in the evaluation of vascular birthmarks. Dermatologic Clinics. 1998 July;16(3):455-88. (PMID: 9704205)
[2] 2. Loar T, Burrows P.E, Hoffer F. Magnetic resonance venography of congenital vascular malformations of the extremities. Pediatric Radiology. 1996;26:371-80. (PMID: 8657472)
[3] 3. Yakes WF. Extremity venous malformations: diagnosis and management. Semin Intervent Radiol 1994;11:332-9.
URL: | https://www.eurorad.org/case/1382 |
DOI: | 10.1594/EURORAD/CASE.1382 |
ISSN: | 1563-4086 |