Case report
Magnetic Resonance Imaging and Ultrasound
Evaluation of Chronic Lateral Malleolar
Bursitis: A Case Report
TD01-TD03
Correspondence
Dr. Jaypradha Saravanan,
Postgraduate Resident, Department of Radiology, Saveetha Medical College and
Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha
University, Chennai, Tamil Nadu, India.
E-mail: jaymdrad@gmail.com
Chronic lateral malleolar bursitis is an unusual cause of lateral ankle swelling that can mimic tendon, joint, or soft-tissue disorders. Present case report is of a 48-year-old male farmer with a 7-month history of painless, fluctuant swelling over the right lateral malleolus. High-frequency Ultrasonography (USG) of the right ankle revealed a focal, well-defined effusion/cystic lesion in the subcutaneous plane/ lateral malleolar bursa, characterised by multiple mobile echogenic lenticular structures (rice bodies) with minimal internal vascularity. Magnetic Resonance Imaging (MRI) of the right ankle revealed T2 weighted (T2W) and Proton Density Fat Saturation (PDFS)- a focal hyperintense fluid collection (effusion)/cystic lesion in the subcutaneous plane/lateral malleolar bursa containing multiple T2W and PD FS hypointense rice bodies, with no involvement of the peroneus tendons, bone marrow, or adjacent neurovascular structures. Aspiration and histopathology revealed fibrinous rice bodies with chronic inflammatory cells with no evidence of granulomatous infection, confirming the diagnosis of chronic lateral malleolar bursitis. This case demonstrates the simultaneous use of USG and MRI to describe the superficial bursae in real time, assess the extent of involvement, and rule out deeper extension.