PMC4623548_01
Palmar view of the left thumb before sclerotherapy at the age of 16.
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F0001
A 16-year-old, right-handed female patient presented with a congenital bluish swelling in the pulp of the left thumb (Figure 1).
A plain radiograph obtained before sclerotherapy shows radiolucent lesions in the distal phalanx of the left thumb.
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F0002
A plain radiograph showed radiolucent lesions in the distal phalanx of the left thumb (Figure 2).
Coronal contrast-enhanced fat-suppressed T1-weighted MRI image obtained before sclerotherapy shows homogenous hyperintense lesions in the palmar soft tissue and distal phalanx of the left thumb. Abbreviation: MRI = Magnetic resonance imaging.
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F0003
Magnetic resonance imaging (MRI) showed lesions in the palmar soft tissue and the distal phalanx of the left thumb (Figure 3).
An intraprocedural contrast radiograph shows the flow through intraosseous and soft tissue lesions of the left thumb.
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F0004
Without a tourniquet, direct puncture of the intraosseous lesion was performed with a bone marrow aspiration needle, then water-soluble contrast material was injected under fluoroscopic guidance to confirm the absence of any dangerous venous drainage (Figure 4).
A plain radiograph at 9 months after the first sclerotherapy shows reduced radiolucent lesions in the distal phalanx of the left thumb.
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F0005
Nine months after the first sclerotherapy, a plain radiograph showed reduced radiolucent lesions in the distal phalanx of the left thumb (Figure 5).
Palmar view of the left thumb at 2 years after the last sclerotherapy.
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F0006
Two years after the last sclerotherapy, the patient had neither swelling nor pain of the left thumb, with no postoperative complications (Figure 6).