Thread by @RyanChristieMD

Wetread Case 30

Hx: foot pain

How about something, anything outside of the chest 😂

Feel free to answer with professionally appropriate gif responses only. No spoilers.
wetread.org #WetreadCow #FOAMrad #FOAMed #radres #errad #mskrad #orthorad and no 🤔 or 🤭! 🤣

Answer: Intraosseous lipoma of the calcaneous

but I bet everyone knew that!

Classic appearance = a well circumscribed lytic lesion in the calcaneal body with central Ca++ (aka cockade sign)

Whats a cockade?

= a rosette - a knot of ribbon rolled into a badge.

So central density surrounded by well circumscribed low density area

Differential diagnosis (for calcaneous):

1) normal triangular lucency in this same area due to the normal stress related trabecular struts (more 🔺 in appearance)

2) Unicameral bone cyst - often very similar looking BUT NO central Calcification

Intraosseous Lipoma:

- most common lipogenic bone tumor
- majority in lower limbs
- ~1/3 in calcaneous**
- most common calcaneal bone lesion**
-CT/MR can confirm internal fat

-often incidental on XR but can present with heal pain

#FOAMrad #FOAMed #radres #mskrad #orthorad

HEEL, not heal.... 🤦‍♂️

little more Chris Farley for you