title: Intramuscular hemangioma mimicking myofascial pain syndrome: a case report.
abstract: Intramuscular hemangioma, an infrequent but important cause of musculoskeletal pain, is often difficult to establish the diagnosis clinically. This report describes a case of a 32-yr-old woman who presented with severe left calf pain for 10 yr. Initial conservative treatments consisting of intramuscular electrical stimulation, herb medication, acupuncture, and intramuscular lidocaine injection under the diagnosis of myofascial pain syndrome in other facilities, failed to alleviate the symptoms. On physical examination, there was no motor weakness or sensory change. Conventional radiography of the leg revealed a soft tissue phlebolith. Conventional angiography study showed hemangioma. Intramuscular hemangioma within the soleus muscle was confirmed by magnetic resonance imaging. Following surgical excision of the hemangioma, the patient's symptom resolved completely. Intramuscular hemangioma is a rare cause of calf pain and should be considered in the differential diagnosis if a patient with muscle pain, particularly if associated with a soft tissue mass, fails to respond to conservative treatment.
authors.affiliation: Department of Physical Medicine & Rehabilitation, Korea University College of Medicine, Ansan Hospital, 516 Gojan-dong, Danwon-gu, Seoul, Korea. rmkdh@korea.ac.kr
authors.forename: Dong Hwee
authors.initials: DH
authors.lastname: Kim
authors.forename: Miriam
authors.initials: M
authors.lastname: Hwang
authors.forename: Yoon Kyoo
authors.initials: YK
authors.lastname: Kang
authors.forename: In Jong
authors.initials: IJ
authors.lastname: Kim
authors.forename: Yoon Kun
authors.initials: YK
authors.lastname: Park
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006391:Hemangioma / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D018482:Muscle, Skeletal / Q000033:anatomy & histology / Q000473:pathology; D009135:Muscular Diseases / Q000175:diagnosis*; D009209:Myofascial Pain Syndromes / Q000175:diagnosis*; D010146:Pain; D011859:Radiography / Q000379:methods; D013997:Time Factors