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Unusual high signal intensity on MR images in a patient with multiple tendinous xanthomas
S Otake1, N Imagumbai, A Tajima
1Department of Radiology, Nagoya City Higashi Municipal Hospital, 1-2-23 Wakamizu, Chikusa-ku, Nagoya, Aichi 464, Japan.
Abstract:
The MR features of a 57-year-old man with multiple tendinous xanthomas are reported. The lesions of the peroneus longus tendons and the Achilles tendons showed diffuse reticulated pattern, which is the typical MR finding of tendinous xanthomas. However, the lesions of the patellar tendons showed no diffuse pattern and contained focal regions of high signal intensity on T 1-weighted images suggesting the deposition of triglycerides. The regions showed high signal intensity on T 2-weighted images and moderate enhancement on contrast-enhanced T 1-weighted images suggesting the presence of associated inflammation.
Insights
Magnetic resonance imaging (MRI) revealed typical patterns in some tendinous xanthomas but unusual findings in others. Focal high signal intensity in patellar tendons suggests triglyceride deposition and inflammation.
Area of Science:
- Radiology
- Orthopedics
- Biochemistry
Background:
- Tendinous xanthomas are a manifestation of lipid metabolism disorders.
- Accurate imaging is crucial for diagnosis and management.
Observation:
- A 57-year-old male patient presented with multiple tendinous xanthomas.
- Magnetic resonance imaging (MRI) was utilized to characterize the lesions.
Findings:
- Peroneus longus and Achilles tendon lesions exhibited a diffuse reticulated pattern, characteristic of tendinous xanthomas.
- Patellar tendon lesions displayed atypical features, including focal high signal intensity on T1-weighted images, indicative of triglyceride deposition.
- These focal regions also showed high signal intensity on T2-weighted images and moderate enhancement, suggesting associated inflammation.
Implications:
- MRI can reveal diverse imaging patterns in tendinous xanthomas.
- Atypical findings may indicate specific underlying biochemical changes, such as triglyceride accumulation and inflammation.
- Further investigation into the biochemical composition and inflammatory status of tendinous xanthomas is warranted.