MRI EXAMINATION OF THE LEFT LOWER EXTREMITY WITH AND WITHOUT CONTRAST

MRI EXAMINATION OF THE LEFT LOWER EXTREMITY WITH AND WITHOUT CONTRAST

INDICATION FOR STUDY:         Cystic mass in the superior left ankle, which was marked.  Soft tissue swelling.  Previous ultrasound examination from XXXXXXX showing a cystic mass measuring up to 2.3 cm.

FINDINGS:               Multiplanar and multisequence imaging was obtained on the Open MRI with and without contrast.  The area of concern was marked.  The patient appears to have some artifact from metallic densities.  The patient also has significant motion artifact on some of the coronal images limiting the examination.  The area of concern is identified and shows no significant abnormal enhancement.  The bony structures appear within normal limits.  There appears to be slight chronic edema in the soft tissues.  The marker was seen on approximately image 8 of series 7 on the post-contrast images.  The cystic area identified on the ultrasound is also identified on the MRI on image 8 of series 6 and image 8 of series 7.  This cystic collection may represent a small hematoma and would recommend clinical correlation.  There does not appear to be solid enhancing lesion or mass.  Given the chronic edema it appears in the soft tissues, it is hard to evaluate, but would recommend clinical correlation and question if there is inflammatory clinical findings to suggest cellulitis.  The possibility of small abscess cannot completely be excluded.  There is no other significant abnormality to the soft tissues, bony structures, or muscle planes clearly identified.

IMPRESSION:         Small cystic mass identified, which correlates with what was seen on the ultrasound examination and on the MRI, it measures approximately 1.5 cm in a craniocaudal direction and 8 mm in the anterior and posterior direction and approximately 2 cm in length.  This correlates with what was seen on the ultrasound examination.  There are some surrounding vessels.  This does not appear vascular in nature.  There is no significant abnormal enhancement once again.

Small cystic collection noted in the subcutaneous soft tissues, which may represent small hematoma.  There appears to be chronic edema in the soft tissues.  Would recommend clinical correlation.  The remainder of the evaluation shows no other significant abnormality or abnormal enhancement and there is no significant solid component.

If there is any further concern, surgical consult and aspiration may be considered if clinically necessary.  Please see comments above.

Thank you for the referral.

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