A cholesterol-containing foreign body granuloma presenting as an inter-metatarsal bursa.
A 68-year-old man presented with progressive forefoot swelling which coincided with the onset of type 2 diabetes mellitus. Imaging revealed a cystic inter-metatarsal mass containing two foreign bodies, which had been present for many years. Following aspiration of the mass, cholesterol crystals were observed on polarised microscopy. It is postulated that the development of diabetes triggered the shedding of cholesterol crystals around a long-standing quiescent foreign body granuloma.
Department of Radiology, Royal Liverpool University Hospital, Prescot Street, Liverpool, L7 8XP, UK. rob.campbell@rlbuht.nhs.uk
R S D
RS
Campbell
R J
RJ
Montgomery
D000368:Aged; D002061:Bursa, Synovial / Q000000981:diagnostic imaging / Q000473:pathology; D002062:Bursitis / Q000150:complications / Q000175:diagnosis*; D002784:Cholesterol; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003937:Diagnosis, Differential; D005528:Foot / Q000000981:diagnostic imaging / Q000473:pathology; D033023:Foot Joints / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D005682:Gadolinium; D015745:Granuloma, Foreign-Body / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D011859:Radiography; D014463:Ultrasonography
D002784:Cholesterol; D005682:Gadolinium