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Juxtacortical Hemangioma

Case Detail

Anatomy: Musculoskeletal
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Benign
Created: over 10 years ago
Updated: over 10 years ago
Tags: PEDS
Modality/Study Types: MR
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Child with lower extremity pain and discoloration.

Case Images


Juxtacortical Hemangioma


MR – Axial T1 and T2, coronal IR and axial and coronal post-gadolinium T1 images of the right leg demonstrate tibial periosteal T2 and post-gadolinium hyperintensity with cortical scalloping.


Osseous hemangiomas most commonly involve the skull and vetebrae. Vertebral hemangiomas usually have a striated appearance. Occasionally vertebral hemangiomas cause neurologic symptoms from spinal cord compression, particularly if these lesions extend into the posterior elements or surrounding soft tissues, expand bone, or fracture. Calvarial hemangiomas arise in the diploic space and are most frequent in the frontal or parietal region. At radiography and CT, a calvarial hemangioma commonly appears as a lytic lesion with a pattern of radiating, weblike or spoke-wheel, trabecular thickening. Osseous hemangiomas in other locations may also have radiating trabecular thickening, a honeycomb pattern or “hole-within-hole” appearance. Bone lysis with a linear and/or circular components suggests a vascular lesion. However, these serpentine vascular channels are recognized more easily with CT and MR imaging. Characteristically, these channels have low signal intensity on T1-weighted images and very high signal intensity on T2-weighted images because of slow blood flow. Periosteal or cortical hemangiomas occur most frequently in the anterior tibial diaphysis and can present as a nonspecific region of bone destruction. Cortical hemangiomas may predispose the bone to fracture, and periosteal reaction may accompany these lesions.


Murphy MD, et al. Archives of the AFIP Musculoskeletal Angiomatous Lesions
Radiologic-Pathologic Correlation. RadioGraphics (1995); 15(4):893-917.

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