INTRAOSSEOUS VENOUS DRAINAGE ANOMALY IN PATIENTS WITH PRETIBIAL VARICES - IMAGING FINDINGS

PURPOSE: To determine a set of distinctive imaging findings seen in sy mptomatic patients with pretibial varices. MATERIALS AND METHODS: Medi cal records and imaging studies of patients who presented with pretibi al varices over an 8-year period were collected from four institutions . Findings in six symptomatic patients with pretibial varices were ret rospectively reviewed. Radiographic and magnetic resonance (MR) imagin g findings were available from all six patients; findings from several other modalities were also available in some patients. RESULTS: Conve ntional radiographs showed a small osteolytic defect in the anterior c ortex of the midtibia and a prominent, longitudinally oriented, radiol ucent groove in the proximal half of the tibial diaphysis. MR images s howed pretibial varices connected to an enlarged vessel in the tibia t hat eventually exited through the nutrient foramen. Computed tomograph ic (three patients), sonographic (four patients), venographic (four pa tients), arteriographic (two patients), and surgical (three patients) findings demonstrated that these patients had an unusual intraosseous varix that traversed the anterior cortex, medullary cavity, and poster ior cortex of the tibia. CONCLUSION: Recognition of these findings can prevent misdiagnosis and may prove helpful in the planning of appropr iate treatment.