| Bilateral tight swollen legs
Dorota Linda1, Ashwyn Rajagopalan2, Samih Salama2, Nader Khalidi3 and Srinivasan Harish1
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History
A
20-year-old female initially presented to the emergency room with a
3-day history of painless swelling involving both legs following
exercise. A deep vein thrombosis was suspected and excluded, but she
continued to have progressive symptoms in her legs over the next
8 months including pain, tightness of muscles, and skin changes (Fig. 1). Magnetic resonance imaging of the bilateral legs was performed (Fig. 2a-c) followed by full thickness skin to muscle biopsy (Fig. 3a-b).
Fig. 1 Photograph of bilateral shin
Fig. 2
a
Axial post gadolinium 3D fast acquisition with multiphase EFGRE
sequence through both calves (giving a T1-weighted fat-saturated type
weighting). b Axial FSE T2-weighted fat-saturated sequence through both calves. c Axial SE T1-weighted fat-saturated sequence through the left calf
Fig. 3
a Histopathology image of the deep fascia (H&E, ×100). b Histopathology image of the fascia (H&E, ×200) with inset view (H&E, ×400). c Histopathology image of the dermis
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