44-year-old male with left lower calf pain and prior ultrasound showing "mass in left groin/calf."IMAGE ACQUISITIONS: Helical scanning through the left lower extremity performed after IV administration of 120 cc of Omnipaque 380 at a rate of 4 cc/sec. Although no discrete mass is seen, there is a poorly defined, tubular structure within the soleus musculature that is difficult to delineate as it is nearly isodense to muscle. On the transverse images (series 7, image 479/699), it is 1.5 cm in diameter and extends for a length of 7 cm as seen on the coronal images (series 80420, image 54/68). It does not have the typical appearance of a soft tissue tumor and may represent either an isolated bundle of muscle or perhaps a venous varix as it does appear to be slightly hyperintense to musculature on coronal images. The possibility of a deep venous thrombus cannot be excluded. Please correlate with ultrasound examination; MRI may be considered for further evaluation if clinically warranted.There is also a 2 cm x 1 cm collection of low density seen between the left femoral vein and the lateral aspect of the pubic bone (series 7, image 70/699), which based on location and density likely either represents a para-labral cyst or fluid within the iliopsoas bursa. No additional mass is evident.
1.Poorly defined, tubular structure in the calf as described above that may either represent a separate muscle bundle or possibly a venous varix. The possibility of a deep venous thrombus cannot be excluded. Correlation with ultrasound examination is recommended; MRI evaluation may be considered if clinically warranted.2.Left hip para-labral cyst versus fluid in the iliopsoas bursa as described above. Findings discussed with Dr. Druelinger of the emergency department at the time of dictation.