Parosteal Lipoma - MSK Radiology
Imaging Findings:
• Frontal radiograph displays a radiolucent soft-tissue mass with internal ossification and septa with adjacent cortical sclerosis of the metatarsal.
• MRI displays a soft-tissue lesion that follows fat-signal intensity on all MR sequences. The lesion has internal thin septa with minimal septal enhancement.
• The lesion is intimately associated with the underlying metatarsal with sclerosis and irregularity of the adjacent cortex.
• Displacement of the adjacent nerves: the medially located deep fibular nerve and lateral positioned dorsal digital nerve.
Case description:
• Fatty lesions that arise from the bone surface.
• Radiolucent soft-tissue lesions on radiographs that often have osseous excrescence (67-100%) with adjacent cortical thickening and periosteal new bone formation of the adjacent osseous structures.
• Follows fat signal intensity on all sequences on MRI.
- MRI may show internal thin septa with minimal internal septal enhancement.
• Most commonly in the femur (appx 33%).
• Increased tracer uptake on bone scan with new bone formation.
• No treatment necessary unless symptomatic due to mass effect or neuropathic symptoms.
Dr. Donald von Borstel @DrvonBorstel
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