Intramuscular lipoma - The Ultrasound Site

Ultrasound Case Study

Intramuscular lipoma

Suresh Sudula, Consultant Physiotherapist and MSK Sonographer

This patient in their 50s  presented with a one year history of a soft tissue lump over the ulna aspect of the right hand. She reported that the lump had been getting slightly bigger over the last few weeks and it was not painful.

A diagnostic MSK ultrasound scan of her right hand in the clinic today showed an ill-defined mixed echogenic inhomogeneous soft tissue mass noted over the hypo thenar eminence of the right hand extending to the ulna border.  The soft tissue mass measured 3.2 x 1.5cm in diameter. There is no vascularity noted on power doppler.  Appearances are consistent with a soft tissue lesion highly suggestive of intramuscular lipoma.

The patient was subsequently referred for an MRI for further clarification, the results of which were  ‘A  soft  tissue  lesion  of  2.8  cm  by  1.5  cm  x  1.5  cm   with  well-defined,  smooth  outline  borders  and  isointense  signal  to fat  in  all  sequences  in  keeping  with  intramuscular  lipoma  of  the  hypothenar  muscles’.

Patient is awaiting surgical removal of the lipoma.

For those who are interested in reading more on intramuscular lipoma’s the following texts provide further information.

A case report of an intermuscular lipoma: presentation, pathophysiology, differential diagnosis. Journal of Chiropractic Medicine,(2010) 9, 127–131

Intramuscular Lipoma of the Supraspinatus Causing Impingement Syndrome. Ferrari et al (2009)  Volume 32 · Issue 8

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