Search

Chronic exertional compartment syndrome is well documented in the distal extremities, but is rare in the thighs. We present the case of a 19-year-old male who presented with chronic, recurrent bilateral thigh pain induced by physical activity, which settled with rest but recurred on immediate return to exercise. Postexercise MRI of both thighs demonstrated changes of symmetrical edema in the proximal quadriceps muscles, reflecting exercise-induce compartment syndrome. The patient underwent selective fasciotomies of each anterior thigh with improvement of symptoms. The patient is now doing well, with some residual milder symptoms and appearances on follow-up MR imaging are not as pronounced. This case describes the clinical presentation and imaging appearance of a rare case of chronic compartment syndrome in the quadriceps femoris.

Denervation pseudohypertrophy is an uncommon cause of limb swelling, which may be overlooked. It is an important diagnosis to arrive at, as it instructs the search for an underlying cause which may itself require intervention. We present the case of a 32-year-old male rugby player with a 2-year history of left calf swelling and intermittent pain and tightness. He described a previous history of 2 left sided lumbar micro-discectomy surgeries. There was no tenderness or sensory deficit on examination. MRI of the left calf revealed muscular enlargement, with fat interspersed between the muscle fibers, in keeping with pseudohypertrophy. This has a number of causes, in this cause attributed to lumbar radiculopathy. This case highlights a rare but important cause of limb swelling which should be considered in the workup of a unilateral swollen limb.

Pigmented villonodular synovitis is a rare benign proliferative disease of synovial membranes, causing villonodular synovial hyperplasia and hemosiderin deposition. Its intra-articular forms most commonly affect the knee and less commonly the hip. PVNS of the hip is most common in the second to fifth decades and presentation is typically with pain and occasionally joint dysfunction. We review the existing literature and demonstrate characteristic magnetic resonance imaging features of pigmented villonodular synovitis in the hip joint using three biopsy-proven cases, with the aims of increasing awareness and aiding diagnosis of this rare but potentially debilitating and progressive condition. Recognition of its clinical presentation, appropriate use of magnetic resonance imaging and identification of imaging characteristics are essential to guiding biopsy interpretation and treatment.

Acetabular paralabral cysts are common. They vary in their clinical presentation and may be asymptomatic or cause pain and restriction at the hip joint. In rare instances they may cause symptoms by compressing local neurovascular structures. We report a case of symptomatic compression of the sciatic nerve by a posteriorly displaced acetabular paralabral cyst.