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Erschienen in: Skeletal Radiology 7/2013

01.07.2013 | Scientific Article

MRI characteristics of nodular fasciitis of the musculoskeletal system

verfasst von: J. Coyle, L. M. White, B. Dickson, P. Ferguson, J. Wunder, A. Naraghi

Erschienen in: Skeletal Radiology | Ausgabe 7/2013

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Abstract

Objective

To evaluate MRI imaging appearances of nodular fasciitis in a pathologic-proven series of 29 patients.

Materials and methods

Review of the orthopedic oncology and pathology databases yielded 51 cases of histologically proven nodular fasciitis. MR imaging was available in 29 patients. Three musculoskeletal radiologists retrospectively reviewed all cases in consensus. Imaging features evaluated included location in the body, size, compartmental localization, relationship to fascia, signal characteristics, enhancement pattern, transcompartmental extension, and osseous and intra-articular involvement.

Results

There were 15 male and 14 female patients. Mean age was 33 years (range, 16–59 years). Lesions ranged in size from 1.6 to 9 cm with 84 % of lesions measuring less than 4 cm. Twenty-three lesions were located in the upper arm or shoulder girdle. Nine lesions were subcutaneous in location, nine were intra-muscular, and 11 were inter-muscular. Lesions were consistently ovoid in shape with broad fascial contact. They exhibited internal homogenous low T1 and heterogeneous intermediate T2 signal with surrounding edema and slightly inhomogeneous enhancement. Twelve lesions exhibited central non-enhancing areas. Trans-compartmental spread was demonstrated in nine lesions. Osseous changes were seen in five cases and included extrinsic cortical saucerization, medullary edema, and transcortical osseous invasion. Two lesions demonstrated intra-articular extension.

Conclusions

MR imaging features of nodular fasciitis are generally non-specific and can be mistaken for a soft tissue sarcoma. This series, the largest MRI series of musculoskeletal cases in the literature, confirms the predilection of nodular fasciitis for the upper extremity in young adults but also demonstrates that aggressive imaging features such as transcompartmental spread, and osseous and intra-articular involvement may be seen in association with this benign soft tissue lesion.
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Metadaten
Titel
MRI characteristics of nodular fasciitis of the musculoskeletal system
verfasst von
J. Coyle
L. M. White
B. Dickson
P. Ferguson
J. Wunder
A. Naraghi
Publikationsdatum
01.07.2013
Verlag
Springer-Verlag
Erschienen in
Skeletal Radiology / Ausgabe 7/2013
Print ISSN: 0364-2348
Elektronische ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-013-1620-9

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