Chronic Muscular haematoma

[Diane]

Hi Steve,
A work colleague said this guy with a lump on his pecs and we were thinking it could be a chronic haematoma?
He said it looked liquidy at the time of scanning and was compressible.

Any thoughts?

Thanks!

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[Stephen Bird]

Interesting one,

I think it depends on the clinical history here,

It could be a chronic haematoma if he has had a gym injury etc,

Or it could be an old rhabdomyolysis from an overuse injury that has damaged the muscle,

It could also be an AVM, even if no flow is seen on Doppler the cavernous AVM’s may demonstrate no flow,

Finally, as it is an intramuscular lesion if there is any concern an MRI can be used to characterise it.

I am always careful with intramuscular lesions that don’t have a memorable injury event. You expect a tear or a rhabdo event to cause this to be memorable and also cause some bruising if it is a tear.

If this history is absent we need to rule out an MRI or sarcoma lesion with an MRI I think,

Steve

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