Learning objectives
Document the radiologic appearance of superficial musculoskeletal fibromatoses,
including ultrasound,
computed tomography and magnetic resonance; explain associated findings in pre- and post-surgical superficial fibromatoses.
Background
Musculoskeletal fibromatoses are grouped in those involving the superficial or the deep tissue,
and they share similar clinical and pathological findings. The superficial fibromatoses include palmar and plantar fibromatosis.
Patients usually present with painless,
subcutaneous nodules that show slow progression into bands that cause traction on the underlying tendons,
resulting in dupuytren’s contracture.
Plantar fibromatoses (Ledderhose disease) are less common and can occur concomitantly,
affecting the middle aspect of the sole of the foot in a similar fashion than its palmar counterpart.
Palmar fibromatosis
Clinical...
Imaging findings OR Procedure Details
Retrospective evaluation of patients with clinically suspected superficial palmar or plantar fibromatosis.
Patient sample was obtained through systematic search of the radiology department database from our institution.
Several patients with clinically suspected superficial fibromatoses performed ultrasound and/or MRI for diagnostic confirmation.
Case 1 - Plantar fibromatosis in a 19 year-old male
Patient complained of a nodular tumefaction on the sole of the left foot.
Ultrasonography revealed a fusiform,
hypoechoic,
heterogenous thickening of the subcutaneous tissue superficial to the proximal insertion of the plantar fascia.
The...
Conclusion
Plantar and palmar fibromatoses have a similar,
although variable,
presentation,
typically hypoecoic or mixed echogenic nodules in the subcutaneous tissue either superficial to the flexor tendons of the hand or adjacent to a thickened plantar aponevrosis.
CT is nonspecific,
butMRI can aid in the diagnosis and pre-surgical distinction of nodules with higher celullarity (more prone to recurrence).
References
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Musculoskeletal fibromatoses: radiologic-pathologic correlation.
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Walker EA,
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Imaging features of superficial and deep fibromatoses in the adult population.
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Plantar and palmar fibromatosis: characteristic imaging features and role of MRI in clinical management.
Rheumatology (2012) 51 (6) : 1134-1136
Omor Y,
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Ledderhose disease: clinical,
radiological (ultrasound and MRI) and anatomopathological findings.
Case reports in Orthopedics (2015) 1-3
Cheung K,
et al....