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Multiple buttock injection granulomas - progressive CT features

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Chronic pain syndrome and inflammatory bowel disease. Has required multiple injections for pain relief.

Patient Data

Age: 50 years
Gender: Female

Incidental finding of multiple foci of calcification projected over the buttocks bilaterally extending more cephalad on the right.

Multiple calcifications in the subcutaneous fat of the buttocks.  

6 years later, these lesions are more calcified and there is more soft tissue swelling.

Case Discussion

Calcification in buttock injection sites is relatively common but this is a particularly exuberant case, reflecting the number of injections into subcutaneous fat rather than muscle causing fat necrosis that is initially seen as soft tissue swelling and then progressively calcifies.

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