MRI of Medial Malleolar Bursa
Robert R. Brown1,2,
Zehava Sadka Rosenberg3,
Mark E. Schweitzer3,
Steven Sheskier4,
Donna Astion5 and
Jeffrey Minkoff6
1 Cleveland Clinic, Cleveland, OH.
2 Current address: Advanced Concepts in Medical Imaging, Ft. Lauderdale,
FL.
3 Department of Radiology, The Hospital for Joint Diseases and New York
University Medical Center, 301 E 17th St., New York, NY 10003.
4 Orthopedic Department, Hospital for Joint Diseases and New York University
Medical Center, New York, NY 10003.
5 St Lukes Roosevelt Hospital Manhattan, New York, NY 10011.
6 Minkoff Sportspedic Associates, PA, Delray Beach, FL.
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Fig. 1. —Drawing of medial malleolar bursa shows medial malleolar bursa is
located in superficial fat adjacent to medial malleolus. Reprinted with
permission from Robert Cravero, Cleveland Clinic, Weston, OH, 2002.
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Fig. 2. —Mild edematous stranding of medial perimalleolar fat in 23-year-old
asymptomatic male volunteer. T2-weighted image (TR/TE, 5,000/80) shows edema
in subcutaneous fat adjacent to medial malleolus (arrows).
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Fig. 3A. —Surgically proven discrete adventitial bursal sac in 22-year-old
female ice skater. Axial T1-weighted (A) (TR/TE, 450/15) and axial
fat-saturated T2-weighted fast spin-echo (B) (2,500/90) images show
mass with well-defined borders and fluid signal characteristics
(arrow) in subcutaneous soft-tissues.
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Fig. 3B. —Surgically proven discrete adventitial bursal sac in 22-year-old
female ice skater. Axial T1-weighted (A) (TR/TE, 450/15) and axial
fat-saturated T2-weighted fast spin-echo (B) (2,500/90) images show
mass with well-defined borders and fluid signal characteristics
(arrow) in subcutaneous soft-tissues.
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Fig. 4. —Surgically-proven discrete adventitial bursal sac in 27-year-old
male ice hockey player. Axial fat-suppressed image (TR/TE, 3,400/43) depicts
mass (arrow) with fluid signal characteristics in subcutaneous fat
posteromedial to medial malleolus. Soft-tissue edema is noted adjacent to
mass.
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Fig. 5A. —Partly scarred down bursal sac in 15-year-old female ice skater.
Patient's symptoms improved with modification of skates. Sagittal T1-weighted
image (TR/TE, 516/18) shows homogeneous mass (arrow) posterior to
posterior tibial tendon (arrowhead). M = medial malleolus.
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Fig. 5B. —Partly scarred down bursal sac in 15-year-old female ice skater.
Patient's symptoms improved with modification of skates. Axial STIR image
(6,300/60) depicts heterogeneous increased signal of mass (arrow),
which is compatible with fibrosis of a bursal sac.
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Fig. 6A. —39-year-old female volunteer with significant soft-tissue swelling
over medial malleolus. Axial T1-weighted (A) (TR/TE, 766/22), axial
T2-weighted (B) (3,000/90), and sagittal STIR (C) (3,300/21)
images show large region of increased signal (arrows, A and
B) in perimalleolar fat superficial to distal tibia. Margins of
edematous area are not well defined (arrowheads, C).
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Fig. 6B. —39-year-old female volunteer with significant soft-tissue swelling
over medial malleolus. Axial T1-weighted (A) (TR/TE, 766/22), axial
T2-weighted (B) (3,000/90), and sagittal STIR (C) (3,300/21)
images show large region of increased signal (arrows, A and
B) in perimalleolar fat superficial to distal tibia. Margins of
edematous area are not well defined (arrowheads, C).
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Fig. 6C. —39-year-old female volunteer with significant soft-tissue swelling
over medial malleolus. Axial T1-weighted (A) (TR/TE, 766/22), axial
T2-weighted (B) (3,000/90), and sagittal STIR (C) (3,300/21)
images show large region of increased signal (arrows, A and
B) in perimalleolar fat superficial to distal tibia. Margins of
edematous area are not well defined (arrowheads, C).
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Copyright © 2005 by the American Roentgen Ray Society.
