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What Is Focus Of Fluid Signal Along The Posterior Distal Femoral Metadiaphysis?

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Posted on Mon, 20 May 2024
Question: the following description concerning?
I’m terrified.
my orthopedic doctor wants me to go to an oncologist due to New focus of fluid signal along the posterior distal femoral metadiaphysis appears to partially envelop the medial gastrocnemius tendon and is favored to represent a large ganglion cyst and less likely reactive periosteal fluid secondary to bone lesion given absence of endosteal scalloping and cortical breakthrough.



Impression
1. Stable size and appearance of heterogeneous 4.7 x 3.5 x 2.3 cm lesion in the distal femoral metadiaphysis with imaging characteristics favoring a bone infarct or low-grade chondroid lesion. Recommend follow-up MRI examination in 8-12 months to ensure long-term stability. However, if there are concerning features on follow-up x-ray or clinical examination such as increased size or pain, a more immediate MRI is recommended for further evaluation.
2. New focus of fluid signal along the posterior distal femoral metadiaphysis appears to partially envelop the medial gastrocnemius tendon and is favored to represent a large ganglion cyst and less likely reactive periosteal fluid secondary to bone lesion given absence of endosteal scalloping and cortical breakthrough.
3. Advanced patellofemoral degenerative changes.



Comparison: MRI of the right femur on 7/29/2023

Technique: Multiplanar multisequence MRI of the right femur with and without contrast was performed on a 1.2 Tesla magnet.

Contrast: 20 cc of Clariscan was administered intravenously. 0 cc was discarded

FINDINGS:

Stable size and appearance of heterogeneous lesion within the distal femoral metadiaphysis with serpentine T2 hyperintense enhancing rim measuring up to 4.7 x 3.5 x 2.3 cm. Lesion demonstrates low T1 and T2 internal signal, which may represent chondroid matrix or fibrosis/sclerosis. There is faint internal enhancement. No T1 hyperintense internal fat signal is identified. Lesion abuts the posterior cortex without significant endosteal scalloping. No perilesional bone marrow edema, cortical breakthrough, or soft tissue component. Prominent nonenhancing fluid along the posterior aspect of the distal femoral metadiaphysis measuring approximately 3.5 x 1.8 x 3.1 cm. Advanced patellofemoral degenerative changes with subchondral cystic change and marrow edema. No knee joint effusion is identified. No Baker's cyst.
doctor
Answered by Dr. Deepak Sundriyal (6 hours later)
Brief Answer:
Hello dear. There is nothing to worry.

Detailed Answer:
Hello dear,
I have gone through your query. I need some more information like
1. For how long(duration) the lesion is there?
2. Is it associated with pain?
3. If associated with pain, it the pain same or increasing?.
As per the reports, it looks like a low grade lesion, means if at all it is tumor, it is very slow growing and not harmful.
Best comfirmation will be by a biopsy, but I would like to avoid biopsy and follow with MRI after 3 months or earlier if new symptom appears or size increases.
Hope it helps.
Feel free to ask further.
Kind regards.
Above answer was peer-reviewed by : Dr. Saisudha Kotla
doctor
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Follow up: Dr. Deepak Sundriyal (9 hours later)
Hi thank you for your reply. I went to mri one lesion and now there are two lesions. There is a new lesion that has formed about 6 months ago. That’s the one they want an oncologist to look into. It doesn’t cause any pain. This is the one associated with the fluid. Because it is new the referred me to an oncologist.

Then there was the first lesion I went to have the mri on and they say it is stable. This has been there for a year with pain that has subsided with a cortisol shots.

Thank you for your help and let me know if I can provide more information.
doctor
Answered by Dr. Deepak Sundriyal (4 hours later)
Brief Answer:
Hello. I will still suggest follow up with mri

Detailed Answer:
Hello dear. So lesions which are fluid filled rather than solid , have very low probability of being cancerous. I will still suggest repeat MRI after 3 months or earlier if if new swelling or change in pain character occurs.
Hence no need to worry as of now.
Kind regards
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Dr.Raju.A.T
doctor
Answered by
Dr.
Dr. Deepak Sundriyal

Oncologist

Practicing since :2005

Answered : 1638 Questions

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What Is Focus Of Fluid Signal Along The Posterior Distal Femoral Metadiaphysis?

Brief Answer: Hello dear. There is nothing to worry. Detailed Answer: Hello dear, I have gone through your query. I need some more information like 1. For how long(duration) the lesion is there? 2. Is it associated with pain? 3. If associated with pain, it the pain same or increasing?. As per the reports, it looks like a low grade lesion, means if at all it is tumor, it is very slow growing and not harmful. Best comfirmation will be by a biopsy, but I would like to avoid biopsy and follow with MRI after 3 months or earlier if new symptom appears or size increases. Hope it helps. Feel free to ask further. Kind regards.