Epithelioid Hemangioendothelioma of the Foot

We describe the case of an 18-year-old male Army reservist presenting with left lower extremity pain for which he was initially diagnosed with a stress injury. After failing conservative treatment, a radiograph was obtained showing a "lacelike" appearance of the medullary bone in the foot and ankle. Magnetic resonance imaging subsequently demonstrated widespread polyostotic marrow replacement with coarsened trabeculations. A biopsy was obtained which diagnosed the patient with polyostotic epithelioid hemangioendothelioma which is the most common malignant vascular tumor of bone. The patient ultimately underwent a below the knee amputation once computed tomography of the chest, abdomen, and pelvis excluded distant metastatic disease. It is important for radiologists to be aware of this diagnosis because osseous epithelioid hemangioendothelioma can present like a stress injury and be mistaken for a less serious diagnosis while potentially having visceral involvement.

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First Necrotizing Fasciitis Caused by Haemophilus influenza Serotype a

Journal of Investigative Medicine High Impact Case Reports ◽

10.1177/2324709617736791 ◽

2017 ◽

Vol 5 (4) ◽

pp. 232470961773679

Author(s):

Giang T. Quach ◽

Jared Frisby ◽

Kurt Kralovich ◽

Mustafa Bohra

Keyword(s):

Lower Extremity ◽

Necrotizing Fasciitis ◽

Skin Infection ◽

Surgical Intervention ◽

High Morbidity ◽

Haemophilus Influenza ◽

Documented Case ◽

Knee Amputation ◽

Left Lower Extremity ◽

Below The Knee

Necrotizing fasciitis (NF) is an infrequently encountered skin infection that has high morbidity and mortality, even with prompt medical and surgical intervention. We describe the case of a 67-year-old male presenting with significant NF in his left lower extremity, despite aggressive surgical intervention, and included multiple surgical debridements, ACell Matrix, split-thickness, and negative wound VAC therapy. Ultimately, this patient required a below the knee amputation. This is the first documented case of Haemophilus influenza type a causing NF.

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Descending Geniculate Artery: The Ideal Recipient Vessel for Free Tissue Transfer Coverage of Below-the-Knee Amputation Wounds

Yearbook of Plastic and Aesthetic Surgery ◽

10.1016/j.yprs.2012.01.023 ◽

2013 ◽

Vol 2013 ◽

pp. 191-192

Author(s):

J. Boehmler

Keyword(s):

Free Tissue Transfer ◽

Recipient Vessel ◽

Knee Amputation ◽

Below The Knee ◽

Tissue Transfer ◽

The Ideal

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Hepatic epithelioid hemangioendothelioma: a report from three university centers

Radiologia Brasileira ◽

10.1590/0100-3984.2015.0059 ◽

2016 ◽

Vol 49 (5) ◽

pp. 288-294 ◽

Cited By ~ 13

Author(s):

Antonello Giardino ◽

Frank H. Miller ◽

Bobby Kalb ◽

Miguel Ramalho ◽

Diego R. Martin ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Epithelioid Hemangioendothelioma ◽

Magnetic Resonance Images ◽

Central Core ◽

Magnetic Resonance Imaging Examination ◽

High Signal ◽

Resonance Imaging ◽

Peripheral Ring ◽

Venous Phase

Abstract Objective: To determine common imaging findings of hepatic epithelioid hemangioendothelioma on magnetic resonance images. Materials and Methods: A search was made of three institutional databases between January 2000 and August 2012. Seven patients (mean age, 47 years; range, 21-66 years; 6 women) with pathology-confirmed diagnosis of hepatic epithelioid hemangioendothelioma who had undergone magnetic resonance imaging were identified. None of the patients had received any treatment for hepatic epithelioid hemangioendothelioma at the time of the initial magnetic resonance imaging examination. Results: Hepatic epithelioid hemangioendothelioma tumors appeared as focal masses in 7/7 patients, greater than 5 in number, with a coalescing lesion in 1/5, and peripheral localization in 6/7. Capsular retraction was present in 4/7, and was associated with peripherally located lesions. Early ring enhancement was appreciated in the majority of lesions in 7/7 patients. Centripetal progressive enhancement was shown in 5/7 patients on venous phase that exhibited a distinctive thick inner border of low signal on venous phase images, and a central core of delayed enhancement. Small lesions did not show this. Conclusion: The combination of multifocal round-configuration lesions that are predominantly peripheral and exhibit early peripheral ring enhancement and late appearance of an inner thick border of low signal and central core of high signal may represent an important feature for hepatic epithelioid hemangioendothelioma.

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Hemoglobin and hematocrit as risk factors in below-the-knee amputation for incipient gangrene

Archives of Orthopaedic and Traumatic Surgery ◽

10.1007/bf00454493 ◽

1988 ◽

Vol 107 (2) ◽

pp. 92-95 ◽

Cited By ~ 4

Author(s):

E. S. Hansen ◽

J.-O. Wethelund ◽

K. Skajaa

Keyword(s):

Risk Factors ◽

Knee Amputation ◽

Below The Knee

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Surgical Management of the Peroneus Quartus Muscle for Bilateral Ankle Pain

Journal of the American Podiatric Medical Association ◽

10.7547/8750-7315-105.1.85 ◽

2015 ◽

Vol 105 (1) ◽

pp. 85-91 ◽

Cited By ~ 2

Author(s):

Nobuaki Chinzei ◽

Noriyuki Kanzaki ◽

Yoshinori Takakura ◽

Yoshiyuki Takakura ◽

Akihiko Toda ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Differential Diagnosis ◽

Rare Case ◽

Lateral Compartment ◽

Lower Leg ◽

Foot And Ankle ◽

Resonance Imaging ◽

Ankle Pain ◽

Accessory Muscle ◽

Muscle Magnetic Resonance Imaging

The peroneus quartus muscle is an accessory muscle seen in the lateral compartment of the lower leg. Although the peroneus quartus muscle is asymptomatic in general, it sometimes becomes pathologic. We present the rare case of bilateral ankle pain with crepitation caused by the peroneus quartus muscle. Magnetic resonance imaging should be considered to assist with diagnosing this condition. Foot and ankle surgeons should consider it in the preoperative differential diagnosis when patients present with posterior ankle pain.

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Foot and ankle functions and deformities focus on posterior tibial tendon dysfunction using magnetic resonance imaging in patients with rheumatoid arthritis

Modern Rheumatology ◽

10.1093/mr/roab084 ◽

2021 ◽

Author(s):

Takeshi Mochizuki ◽

Yuki Nasu ◽

Koichiro Yano ◽

Katsunori Ikari ◽

Ryo Hiroshima ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Pitch Angle ◽

Posterior Tibial Tendon ◽

Foot And Ankle ◽

Resonance Imaging ◽

Posterior Tibial Tendon Dysfunction ◽

First Metatarsal ◽

Posterior Tibial ◽

Metatarsal Angle

ABSTRACT Objectives Posterior tibial tendon dysfunction (PTTD) affects the support of the medial longitudinal arch and stability of the hindfoot. The purpose of this study was to assess the relationships of PTTD with foot and ankle functions and foot deformities in patients with rheumatoid arthritis (RA). Methods A total of 129 patients (258 feet) who underwent magnetic plain and contrast-enhanced magnetic resonance imaging were enrolled in this study. Positive magnetic resonance imaging findings were defined as tenosynovitis and incomplete and complete rupture of the posterior tibial tendon. Foot and ankle functions were assessed using the Japanese Society for Surgery of the Foot standard rating system for the RA foot and ankle scale (JSSF-RA) and self-administered foot evaluation questionnaire. Plain radiographs were examined for the hallux valgus angle, first metatarsal and second metatarsal angle, lateral talo-first metatarsal angle, and calcaneal pitch angle. Results PTTD was associated with motion in the JSSF-RA (p = .024), activities of daily living in JSSF-RA (p = .017), and pain and pain-related factors in the self-administered foot evaluation questionnaire (p = .001). The calcaneal pitch angle was significantly lower in the feet with PTTD than in those without PTTD (median: 16.2° vs. 18.0°; p = .007). Conclusions The present study shows that PTTD was associated with foot and ankle functions and flatfoot deformity. Thus, a better understanding of PTTD in patients with RA is important for the management of foot and ankle disorders in clinical practice.

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Salvage of a Below-the-Knee Amputation Level Following a Type-IIIB Open Tibial Fracture

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.g.00556 ◽

2007 ◽

Vol 89 (12) ◽

pp. 2769-2778 ◽

Cited By ~ 4

Author(s):

Steven J Morgan ◽

Justin Newman ◽

Kagan Ozer ◽

Wade Smith ◽

Raffi Gurunluoglu

Keyword(s):

Tibial Fracture ◽

Open Tibial Fracture ◽

Amputation Level ◽

Knee Amputation ◽

Below The Knee ◽

Type Iiib

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The Boyd amputation as a treatment for osteomyelitis of the foot

Journal of the American Podiatric Medical Association ◽

10.7547/87507315-90-5-234 ◽

2000 ◽

Vol 90 (5) ◽

pp. 234-239 ◽

Cited By ~ 5

Author(s):

JF Grady ◽

CL Winters

Keyword(s):

Surgical Technique ◽

Knee Amputation ◽

Below The Knee ◽

Heel Pad ◽

Difficult Procedure ◽

Syme Amputation

The Boyd amputation is a surgical technique used to treat osteomyelitis of the foot. This amputation is a technically more difficult procedure to perform than the Syme amputation, but it offers certain advantages. The Boyd amputation provides a more solid stump because it preserves the function of the plantar heel pad. Also, because a portion of the calcaneus is left and fused to the tibia, the weightbearing surface is more solid than in the case of a Syme amputation. The authors recommend a Boyd amputation as an alternative to a Syme or a below-the-knee amputation to treat patients with osteomyelitis of the forefoot and midfoot.

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