Forefoot pain. No hindfoot symptoms.
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A well circumscribed lytic lesion with narrow zone of transition, thin rim of sclerosis, defined calcification in matrix and low radiodensity.
The top two differential diagnosis of anterior calcaneal well defined lytic lesions are:
- simple bone cyst
The presence of a benign pattern of calcification such as spiculated or rim calcification within such lesions in the anterior calcaneum is almost pathognomonic of a lipoma.
Diagnosis can be confirmed by MRI, or in large lesions like this one by CT.
- Intraosseous lipomas: radiologic and pathologic manifestations. DOI: http://dx.doi.org/10.1148/radiology.167.1.3347718