Haemophiliac bleed

Case contributed by Dr Jeremy Jones

Presentation

Pain in the left groin following trivial trauma. History of haemophilia.

Patient Data

Age: 15 years
Gender: Male
Modality: MRI

Large intramuscular haematoma in the posteromedial left hip.

1 month later

Modality: MRI

There has been expansion of the previously demonstrated haematoma. Features remain appropriate for the diagnosis, especially since the patient has haemophilia and the onset of symptoms followed trauma and was acute.

Modality: MRI

The size of the lesion has decreased in size, but post-contrast there is peripheral enhancement and enhancement of oedema (which is not uncommon).  Contrast had not previously been given.

Modality: MRI

Complete resolution of the left hip haematoma.

Case Discussion

The series of MRI examinations demonstrate an enlarging intramuscular haematoma that regresses completely within a year. Haematomas can have extremely aggressive imaging characteristics, especially when contrast is administered. Without an appropriate history, making a confident diagnosis may not be possible.

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Case Information

rID: 24067
Case created: 26th Jul 2013
Last edited: 27th Feb 2016
Inclusion in quiz mode: Included

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