Morphea (localised scleroderma)
Painful leg. Rash.
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Oedema and thickening of the deep fascia is shown to extend circumferentially around the calf from the level of the junction of middle and distal thirds of tibia to the proximal calf.
Muscle oedema is seen within the medial and lateral heads of gastrocnemius just proximal to the myotendinous junction.
There is further under induration of subcutaneous fat laterally in the mid calf overlying the peroneal compartment with oedema in the adjacent peroneal muscle.
Appearances are consistent with morphea involving the deep fascia of the calf, periosteum over the anteromedial margin of the tibia, the gastrocnemius muscles, peroneal muscles, tibialis posterior tendon sheath and the skin and subcutaneous tissues over the medial malleolus and over the peroneal compartment.
Morphea biopsy proven over left medial malleolus further induration up shin. MRI was performed to assess extent including subcutaneous extent.
Morphea is localised scleroderma, and the term is morphea is more common in dermatology.
Case courtesy Dr Patsy Robertson.