Case Challenge

Stephen J Pomeranz

Gain confidence interpreting Soft Tissue Masses on MRI with MRI Online. Quiz yourself using real-world, interactive scrollable cases & earn CME. Try it free!

X-Ray (Plain Films)

Case Review

Musculoskeletal (MSK)

Case 1 - 46-year-old female reports with lump in the distal shin

Case 2 - 43-year-old male presents with back and bilateral leg pain

Case 3 - 53-year-old male presents with history of shoulder pain

Case 4 - 63-year-old female reports with a history of otalgia

Case 5 - 48-year-old male is being evaluated for a soft-tissue mass

Case 6 - 61-year-old female reports with occasional discomfort at site of right shoulder mass

Case 7 - 65-year-old female reports with a history of giant cell tumor of tendon sheath

Case 8 - 15-year-old female is being evaluated for dorsal soft tissue mass

Case 9 - 63-year-old female reports with history of abnormal plantar soft tissue mass

Case 10 - 29-year-old female reports with left wrist discomfort

Case 11 - 57-year-old male presents with a history of fractured toe as a child

Case 12 - 42-year-old female reports with history of soft tissue mass

Case 13 - 69-year-old male presents with right knee pain and swelling

Case 14 - 72-year-old female presents with history of soft tissue mass, ganglion, thumb pain

Case 15 - 31-year-old male reports with with enlarging soft tissue mass

Case 16 - 40-year-old female presents with soft tissue mass distal forearm

Case 17 - 57-year-old male reports with history of deformity of bone

Case 18 - 48-year-old male reports with history of trauma in left finger

Case 19 - 60-year-old female presents with a soft tissue mass for 15 years

Case 20 - 55-year-old female presents with an anterior vaginal mass

Case 21 - 46-year-old female presents with salivary gland disorder

Case 22 - 35-year-old male presents with complaint of dorsal cyst

Case 23 - 69-year-old female reports with soft tissue mass of several months

Case 24 - 24-year-old male reports with left forefoot pain

Case 25 - 80-year-old male presents with right-sided liver mass

Course Evaluation

Post-Course Activities

This Power Pack is comprised of 25 unique Soft Tissue Masses (STM) MRI cases that you can scroll through in our diagnostic web viewer to determine your findings. Quiz yourself and earn CME.

Soft Tissue Masses MRI Cases

<div>HISTORY:&#160;This 57-year-old male presents with a history of fractured toe as a child with persistent great toe mass that reportedly has been growing for the past 30 years. No history of prior surgery.(QUIZ ANSWER) NOT A FINDING:&#160;The mass demonstrates homogeneous increased T1 signal intensity.Using the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS: An ovoid, well-encapsulated, soft tissue mass lies dorsal to the extensor hallucis longus tendon at the distal interphalangeal joint and extends medially. This demonstrates homogeneous decreased T1 signal intensity and heterogeneous, but primarily increased signal intensity on the STIR images. This measures 2.7 x 2.0 x 1.5cm in length, width and thickness respectively. No invasion of the osseous structures. The intrinsic signal intensity of the osseous structures adjacent to this region are well maintained. Soft tissues adjacent to this mass unremarkable.&#160;Hallux valgus deformity at the 1st metatarsophalangeal joint with degenerative changes manifested by chondromalacia and adjacent osteophytes. Chondromalacia of the sesamoids without sesamoiditis.&#160;Intrinsic signal intensity of the osseous structures and joint spaces elsewhere well maintained. The visualized portions of the extensor and flexor digitorum longus tendons intact as is the plantar aponeurosis.&#160;CONCLUSION:&#160;1. Well-encapsulated, dorsal soft tissue mass abutting the extensor hallucis longus tendon at the distal interphalangeal joint with dimensions as described above. Based on the location, signal intensity and areas of involvement, fibroma of tendon sheath or giant cell tumor of the tendon sheath should be considered. Favor excisional removal.2. Arthropathy at the 1st metatarsophalangeal joint with mild hallux valgus deformity.</div>

Case

The mass lies dorsal to the extensor hallucis longus tendon at the distal interphalangeal joint and extends medially

The mass demonstrates homogeneous increased T1 signal intensity

The mass  demonstrates heterogeneous, but primarily increased signal intensity on the STIR images

Fibroma of tendon sheath, or giant cell tumor of the tendon sheath, should be considered

Regarding the mass in this case, which of the following is NOT correct?