PMC4721877_01
Anteroposterior and lateral radiograph of the left femur shows barely visible lytic lesion within meta-diaphysis of distal left femur, comparing to the right side (arrow). No periosteal reaction and cortical destruction is noted.
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F1
Plain film radiographs [AP and Lateral views] showed a barely visible medullary expansion and lucency in the distal left femoral diaphysis. [fig 1a, b].
Axial CT scan slice from distal both thighs shows a well-defined lesion with fat attenuation in the central part of left femur(arrow).
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F2
(a): Acoronal spin-echo T1-weighted MR image (TR/TE, 400/11) shows high signal tubular intra medullary lesion in the distal femur (black arrow) with small relatively low signal in it's distal metaphyseal part (white arrow) whichis probably due to degeneration or edema in the lipoma. The major part of the lesion consisted of areas of isosignal intensity with subcutaneous fat. (b & c) An axial and sagittal spin-ech and sagittal T2-weighted MR image (TR/TE, 2600/84) shows a hyperintense lesion iso-signal with the subcutaneous fat (black arrow).
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F3
T1-weighted MR images revealed an intramedullary lesion with a greater intensity than that of soft tissue and equal signal intensity to subcutaneous fat [Fig. 3a]. T2-weighted images also showed a high signal intramedullary lesion similar to subcutaneous fat [Fig. 3: b,c].
sagittal fat saturation proton density image, shows reduced signal of the intramedullary mass similar to subcutaneous fat (white arrow). Small mildly high signal area in metaphysis is probably due to degeneration or edema within the lipoma (black arrow).
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F4
The inferior border of the lesion in the diaphysis of distal femur and also adjacent meta-epiphysis showed high signal intensity in favor of post traumatic edema and adjacent bone bruise [Fig. 4].