Lipoma OR Not

[Samuel Katumba]

Hi Steve,
I have scanned patients with lumpiness in the lower back (just in upper buttock area).
In this area, I see a ‘Lipoma like’ mass. What surprises me is this ‘mass’ usually has a breached capsule and on compression, it looks like how a reducible supra umbilical hernia would look like. What’s this?

Also, I have scanned supraclavicular lumps that are visible clinically, however what I see Sonographically, is not convincing for Lipoma. ???

Thanks,
Samuel.K

[Stephen Bird]

Howdy Samuel,

There is a few options here.
Just above the posterior iliac crest you can get a triangle of Petit (inferior lumbar space) hernia that can look like you describe.
A little bit higher you can get a space of Grynfelt (superior lumbar space) hernia.
I have attached a video file of a space of Grynfelt hernia where I thought the kidney was going to fall out!

On the other hand, you could be looking at normal adipose.

Do you have images or clips for me to review.

Se you in London soon!!!

Steve

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