Presentation
Painless enlarging lump in the anterior thigh. No history of recent trauma. Does play football.
Patient Data
Suggestion by another reporting radiologist to exclude "sarcoma"
Despite the dense calcification on US and x-ray, the mass is T2 hyperintense with minor susceptibility artefact on the gradient echo sequence. The mass also enhances peripherally and is centered on the central tendon of the rectus femoris.
Markedly echogenic mass with shadowing indicative of calcification in the quadriceps muscle. No associated non-calcified mass.
Subtle but well-circumscribed calcification in the anterior thigh at the site of the patient's palpable swelling.
Case Discussion
This is an important diagnosis to make radiologically so as to avoid biopsy. It actually looks more "sinister" on MRI than X-ray or US. Keys to the diagnosis are the circumscribed calcification on X-ray, location that is prone to trauma in the anterior thigh, and intimate relationship to the rectus femoris tendon.