Vague lump in the right perianal region.
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Focal signal abnormality within fat in bilateral ischiorectal fossae, more marked on right side, where a central low signal intensity non-enhancing region, suggestive of a mature fibrous tissue. Surrounding wider zone of enhancing granulation tissue is seen.
Based on the findings, which are clearly away from the anal canal, direct questioning revealed that the patient is an avid bicyclist.
The changes of fibrosis and enhancing edematous soft tissues at pressure points are consistent with chronic pressure-related fibrosis, commonly described as a "Biker's nodule".
- Stefaan Van de Perre, Filip M. Vanhoenacker, Luc Vanstraelen, Jan Gaens, Maarten Michiels. Perineal nodular swelling in a recreational cyclist: diagnosis and discussion. (2009) Skeletal Radiology. 38 (9): 933. doi:10.1007/s00256-009-0731-9