EURORAD ESR

Case 8960

Aggressive reactive periostitis (ECR 2010 Case of the Day)

Author(s)
Llopis E, Belloch E
Radiology Department, Hospital de la Ribera, Valencia, Spain.
 
Patient
female, 41 year(s)
 
 
  • Figure 1
    Plain films of the hand
     

    Posteroanterior plain film. 4th finger shows soft tissue swelling, calcifications and paraosteal-periosteal reaction of the proximal phalanx.

     
    Area of Interest: Bones; Imaging Technique: Conventional radiography;

    Oblique plain film. Soft tissue swelling, increased density, calcifications and paraosteal-periosteal reaction.

     
     
     
  • Figure 2
    US, transverse and longitudinal plane
     

    Transverse plane. Soft tissue mass with sound attenuation.

     

    Longitudinal plane

     
     
     
  • Figure 3
    MRI of the 4th finger. Axial T1W image

    Ill defined soft tissue mass iso or slightly hyperintense to muscle. Cortex is intact and there is no continuity with bone marrow.

     
     
     
  • Figure 4
    Sagittal FSE fat-suppressed image

    The lesion is hyperintense to muscle.

     
     
     
  • Figure 5
    Sagittal gradient echo image

    Periosteal mass with foci of susceptibility artefact due to calcifications.

     
     
     
  • Figure 6
    Post-contrast axial T1w image

    Mass shows intense enhancement after gadolinium injection.

     
     
     
  • Figure 7
    MDCT images
     

    Three-dimensional volume rendering CT image demonstrates periosteal proliferation.

     

    Sagittal MPR CT image demonstrates soft tissue calcifying periosteal mass without cortical involvement.

     
     
     
Posteroanterior plain film. 4th finger shows soft tissue swelling, calcifications and paraosteal-periosteal reaction of the proximal phalanx.
 
Oblique plain film. Soft tissue swelling, increased density, calcifications and paraosteal-periosteal reaction.
 
Transverse plane. Soft tissue mass with sound attenuation.
 
Longitudinal plane
 
Ill defined soft tissue mass iso or slightly hyperintense to muscle. Cortex is intact and there is no continuity with bone marrow.
 
The lesion is hyperintense to muscle.
 
Periosteal mass with foci of susceptibility artefact due to calcifications.
 
Mass shows intense enhancement after gadolinium injection.
 
Three-dimensional volume rendering CT image demonstrates periosteal proliferation.
 
Sagittal MPR CT image demonstrates soft tissue calcifying periosteal mass without cortical involvement.
 
 
 
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