Presentation
Painful leg. Rash.
Patient Data
Edema and thickening of the deep fascia is shown to extend circumferentially around the calf from the level of the junction of middle and distal thirds of tibia to the proximal calf.
Muscle edema is seen within the medial and lateral heads of gastrocnemius just proximal to the myotendinous junction.
There is further induration of subcutaneous fat laterally in the mid calf overlying the peroneal compartment with edema in the adjacent peroneal muscle.
Conclusion:
Appearances are consistent with morphea involving the deep fascia of the calf, periosteum over the anteromedial margin of the tibia, the gastrocnemius muscles, peroneal muscles, tibialis posterior tendon sheath and the skin and subcutaneous tissues over the medial malleolus and over the peroneal compartment.
Case Discussion
Morphea was biopsy-proven from the skin overlying the left medial malleolus. MRI was performed to assess extent including subcutaneous extent.
Morphea is the term for localized scleroderma, and the term morphea is more commonly used in dermatology.
Case courtesy Dr Patsy Robertson.
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