Season 8 Case 30

Season 8 Mar 26, 2020

History: foot pain

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



Professor of the Darkroom Arts

Great! You've successfully subscribed.
Great! Next, complete checkout for full access.
Welcome back! You've successfully signed in.
Success! Your account is fully activated, you now have access to all content.