Case Of the Week (COW) 09 August 2015
Iliacus hematoma
Findings
CT-Predominantly hyperdense lesion in the right iliacus muscle,causing displacement and compression of the right iliac vessels and lateral wall of the bladder and cortical scalloping of the right iliac bone,does not show enhancement on contrast imaging.
Discussion
The above mentioned findings of predominantly hyperdense lesion in the right iliacus muscle which does not enhance on contrast imaging in a patient with history of common pathway defect is suggestive of hematoma.Spontaneous hematomas of the iiacus muscle are rare lesions seen in patients on anticoagulant therapy or blood dyscrasia,like hemophilia.Rarely it can be seen even in healthy individulas. It commonly presents with pain in the groin,hip,thigh and can cause femoral neuropathy and quadriceps weakness. Hematoma responsible for femoral neuropathy is necessarily situated in the iliacus uscle and not in psoas muscle Iliacus hematomas never drain spontaneously.They persist and may cause chronic compression CT is the imaging modality of choice and treatment protocol is controversial because of the rareness of the lesion.
Contributed By:
Prof. S Babu Peter, Dr.K. Geetha, Dr. S. Kiruthika
Barnard Institute of Radiology
Iliacus hematoma
Findings
CT-Predominantly hyperdense lesion in the right iliacus muscle,causing displacement and compression of the right iliac vessels and lateral wall of the bladder and cortical scalloping of the right iliac bone,does not show enhancement on contrast imaging.
Discussion
The above mentioned findings of predominantly hyperdense lesion in the right iliacus muscle which does not enhance on contrast imaging in a patient with history of common pathway defect is suggestive of hematoma.Spontaneous hematomas of the iiacus muscle are rare lesions seen in patients on anticoagulant therapy or blood dyscrasia,like hemophilia.Rarely it can be seen even in healthy individulas. It commonly presents with pain in the groin,hip,thigh and can cause femoral neuropathy and quadriceps weakness. Hematoma responsible for femoral neuropathy is necessarily situated in the iliacus uscle and not in psoas muscle Iliacus hematomas never drain spontaneously.They persist and may cause chronic compression CT is the imaging modality of choice and treatment protocol is controversial because of the rareness of the lesion.
Contributed By:
Prof. S Babu Peter, Dr.K. Geetha, Dr. S. Kiruthika
Barnard Institute of Radiology