Presentation
Long history of elbow pain, particularly at night. Occasional swelling. No trauma.
Patient Data
There is an extensive multifocal intramuscular abnormality in the dorsal aspect of the arm at the elbow. The lesion comprises multiple hypoechoic rounded and ovoid areas. It is compressible, and there is no significant vascularity.
On MRI, the lesion is significantly more extensive than was demonstrated on the ultrasound. It is intramuscular, but spread across several muscles. No phleboliths. Multiple fluid-fluid-levels. No edema. Appearances are characteristic of a venous vascular malformation.
Case Discussion
Appearances on US and MRI are of a venous vascular malformation. The presence of fluid-fluid levels in cystic spaces on the MRI should not put you off the diagnosis. There are no concerning features.
Injection sclerotherapy was performed with significant improvement in symptoms after just 1 treatment.
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