Hemophiliac 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
MRI

Large intramuscular hematoma in the posteromedial left hip.

MRI

1 month later

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

MRI

3 months

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

MRI

9 months

Complete resolution of the left hip hematoma.

Case Discussion

The series of MRI examinations demonstrate an enlarging intramuscular hematoma that regresses completely within a year. Hematomas 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
Published: 26th Jul 2013
Last edited: 15th Aug 2018
Inclusion in quiz mode: Included

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