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Calcaneal lipoma

Case contributed by Piyush P Siwach
Diagnosis almost certain

Presentation

Forefoot pain. No hindfoot symptoms.

Patient Data

Age: 60 years
Gender: Male
x-ray

A well circumscribed lytic lesion with narrow zone of transition, thin rim of sclerosis, defined calcification in matrix and low radiodensity.

Case Discussion

The top two differential diagnosis of anterior calcaneal well-defined lytic lesions are:

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 an intraosseous lipoma. 

Diagnosis can be confirmed by MRI, or in large lesions like this one by CT.

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