J-LSMS 2014 | Annual Archive

Journal of the Louisiana State Medical Society

R adiology C ase of the M onth Uncommon Masses in Renal Disease

Juan S. Gomez, MD; Enrique Palacios, MD; FACR; Jeremy B. Nguyen, MD; Harold R. Neitzschman, MD (Section Editor)

CASE ONE

A 26 year-old female with fever, tachycardia and pain in her left lower extremity, presented to the Emergency Depart- ment. Past medical history is remarkable for hypertension, end stage renal disease requiring hemodyalisis and arteriovenous fistula (AVF). The AVF was performed in the left thigh undergoing superimposed infection. Physical examination revealed a fixed, non-erythematous tender mass at the left hip and an area of erythema, edema and induration at the surgical incision site of the arteriovenous access previously obtained at the left thigh. Blood chemistry values revealed hyperposphatemia and normocalcemia. Computer Tomography (CT) of the left hip with contrast was ordered.

Figure 1B

Figure 1A

Figure 1 : Computed Tomography of the left hip without contrast. (A) Coronal, (B) axial and (C) sagittal projections. Fluid levels present in both (B) and (C) .

Figure 1C

264 J La State Med Soc VOL 166 November/December 2014

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