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 42-year-old female reports with history of soft tissue mass around 4th and 5th metatarsal distal aspect.(QUIZ ANSWER) LEAST LIKELY DIFFERENTIAL:&#160;Fibroma of tendon sheath.Using the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS:Dumbbell shaped 1.7cm (AP) x 0.8cm (CC) x 0.6cm (ML) solid mass is identified in the 4th intertarsal space. The mass demonstrates T1 intermediate intensity (slightly higher intensity than musculature), T2 intermediate signal intensity (higher than musculature but lower than fat tissue), STIR increased signal intensity lesion, and mild contrast enhancement.&#160;&#160;No Morton's neuroma.Bones about the forefoot are intact without evidence of macrofracture or contusion. No substantive arthropathic change is seen. Lisfranc ligament and joint space are intact.&#160;A capsulobursal cyst is noted at the dorsal aspect of the intermediate cuneiform, likely arising from the medial and intermediate cuneiform articulation.&#160;Musculature about the plantar compartment is intact. No atrophy or denervation.&#160;No substantive arthropathic change in metatarsophalangeal joints. Sesamoid bones are intact. Mild capsulitis of 1st, 2nd and 3rd metatarsophalangeal joints. No evidence of synovitis.&#160;Visualized aspects of the plantar fascia are normal.&#160;Plantar plates are intact. Callus formation at the plantar aspect of the hallux joint and the dorsal aspect of the 5th distal phalanx.4th through 5th hammertoes.&#160;CONCLUSION:&#160;1. Dumbbell shaped 1.7cm (AP) x 0.8cm (CC) x 0.6cm (ML) benign appearing solid mass in the 4th intertarsal space. Differential considerations include epidermoid, giant cell tumor of the tendon sheath and traumatic neuroma. Fibroma of tendon sheath less likely. Consider removal.2. Mild capsulitis of hallux joint and 2nd and 3rd metatarsophalangeal joints.</div>

Case

Which of the following is the LEAST likely differential diagnosis?