Psuedomass - dorsum of foot

Case contributed by Maulik S Patel
Diagnosis almost certain

Presentation

Bilateral dorsal foot bumps - few months. Mild pain on compression. No trauma.

Patient Data

Age: 65 years
Gender: Male
Photo

Both feet show dorsal region two bumps. The medial ones are larger than the lateral ones.

x-ray

Bilateral plantar calcaneal bone spurs, arterial wall calcification, dorsal mid-foot soft tissue thickening. No fracture/ dislocation/ bone lesion/ periosteal reaction.

ultrasound

Normal extensor hallucis brevis and extensor digitorum brevis muscles on both sides. Normal overlying subcutaneous fat. No solid/ cystic mass lesion/ tenosynovitis on either side.

Annotated image

The medial more prominent bump is the extensor hallucis brevis muscle. The lateral less prominent bump is the extensor digitorum brevis muscle.

Case Discussion

The patient presented with bilateral foot dorsum bumps, two on each side. The ultrasound shows the more prominent medial bump due to the extensor hallucis brevis muscle. The more minor lateral bump is the extensor digitorum brevis. Both muscles show normal echopattern. The clinically visible masses are pseudomasses caused by muscle hypertrophy.

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