Hemangioma of First Extensor Compartment of the Wrist– A Rare Case Report

Abstract

Introduction: Although upper extremity intramuscular hemangioma is a rare clinical entity, it poses considerable morbidity in the functional needs of an individual. The diagnosis of intramuscular hemangioma poses a diagnostic glitch. The combined radiological and histopathological assessment provides a complete understanding and diagnosis for the same. Every tumor follows an individualized protocol for its management. Case Report: A 15-year-old female presented with swelling over dorsal aspect of distal 1/3rd right forearm, which was 3 cm away from the articular surface of the right wrist from the past 5 years. There was no history of trauma or infection over the right wrist. Finkelstein’s test was negative, which rule out de Quervain’s tenosynovitis. The movements of the right wrist were unrestricted without any distal neurovascular deficit. MRI of her right wrist and hand suggested the presence of low flow vascular malformation within the musculotendinous junction of APL and EPB muscles. The patient underwent excision biopsy of the hemangiomatous lesion in toto without any neurological complications. No recurrence was noted in the follow-up period for 6 months. Conclusion: Being a benign vascular tumor, MRI provides the gateway to diagnose intramuscular hemangioma for early intervention to provide better functional results. The choice of definitive treatment for APL and EPB hemangioma was excision biopsy in toto which provided better functional results in our patient. Keywords: Hemangioma, intramuscular, abductor pollicis longus, extensor pollicis brevis, MRI, excision biopsy.

Pediatric cartilaginous lateral femoral condyle Hoffa fracture: a case report and review of the literature

“…The oblique view provides better visualization of minimally displaced fractures [ 13 ]. While CT scanning is the gold standard for characterization and diagnosis of Hoffa fractures [ 18 ], due to the radiological exposure risk in younger patients, MRI is preferred. In this case, the initial radiographic report described an osteochondritis dissecans lesion, which led to the Hoffa fracture being later diagnosed on an MRI scan.…”

Hoffa's fracture of the medial femoral condyle in child

“…Hoffa's fracture is defined as a fracture of the femoral condyle in the coronal planes. It was first described in 1904 by Hoffa [ 1 ]. This fracture is uncommon in adults and very rare in paediatric population [ 2 ].…”

“…This fracture is uncommon in adults and very rare in paediatric population [ 2 ]. It may involve either one or both the femoral condyles, but it more common in the lateral one [ 1 ]. Isolated medial Hoffa fracture in a child is extremely rare.…”

“…In children, it can be due to sports injurie, trivial injury and motor vehicle accident [ [5] , [6] , [7] ]. Falling of heavy object on the knee was also reported [ 1 ]. The diagnosis of this fracture can get missed in routine radiographs of distal femur.…”

“…The diagnosis of this fracture can get missed in routine radiographs of distal femur. CT-scan is mandatory for the diagnosis and 3D reconstruction helps to delineate proper orientation of the fracture line [ 1 ]. In immature skeleton, this fracture corresponds to Salter and Harris type 4 fractures.…”