PMC7712411_01
Injury of the vastus medialis muscle, which was visible on the clinical examination of the lower thigh. Parental consent was obtained for publication of this clinical photograph.
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At clinical examination, the girl showed functional impairment of the right knee (limited flexion of 30%), muscle contracture, and localized pain (Figure 1).
Preoperative magnetic resonance imaging. (a) Focal mass-like FAVA, which produced progressive thigh pain over the last year; (b) the sagittal image shows maximal mass hyperintensity in T2-weighted images.
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T1-weighted MRIs showed heterogeneous and hyperintense signal related to the fat component (Figure 2), and the injection of intravenous contrast clearly revealed the malformed venous component. The solid mass was found to have partially replaced the normal vastus medialis muscle fibers, with fibrofatty overgrowth and varied appearances of clusters of thick-walled muscular vessels; multiple soft-tissue planes were found to be involved as well, showing hypoechoic intralesional clots or development of phleboliths, with low-flow venous parameters that were also barely detectable by Doppler sonography.