Muscle oedema secondary to calf DVT on MRI

Case contributed by Dr Chris O'Donnell

Presentation

Known leukocytoclastic vasculitis. Now severe right calf pain, ? myositis

Patient Data

Age: 40
Gender: Male

MRI to detect sites of myositis prior to targetted biopsy

Modality: MRI

Diffuse oedema in the gastrocnemius and soleal muscles of the right leg associated with expansion of the calf veins filled with T1 and T2 hyperintense material indicative of clot.  All other calf and thigh muscles are normal.  Note left calf veins do not contain T1 hyperintensity i.e. methaemoglobin.

Case Discussion

MRI (especially STIR imaging) is exquisitely sensitive to muscle oedema and can be used to localize sites of muscle swelling that be targetted for biopsy (to diagnose myositis).  It is, however, no specific as in this case i.e. the patient has muscle swelling not due to inflammation rather due to venous obstruction by thrombosis.

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Case Information

rID: 42523
Case created: 25th Jan 2016
Last edited: 6th Nov 2016
Inclusion in quiz mode: Included

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