X-ray diagnosis of macrodystrophia lipomatosa

Abstract

Macrodystrophia lipomatosa is an unusual form of local hypertrophy. It is congenital in origin, marked by increase in all the mesenchymal elements, particularly fibro-adipose tissue. There is no predilection for either sex. It is normally noticed at birth, and as the patient grows, consultation may be sought regarding cosmetic surgery. One or more of the digits of the hand or foot are affected. Mechanical problems may supervene in adolescence with secondary osteoarthritis and/or compression of neurovascular structures. We report two cases with emphasis on the X-ray changes and differential diagnosis. An 18-year-old girl presented to the Casualty Department having grazed the third digit of her left foot two days previously. The toe was now tender and grossly swollen. History revealed that she was born with hypertrophy of the second, third and fourth toes of the left foot. She was operated on at one year of age, when she had amputation of the terminal phalanx of the third toe and osteotomy of the proximal phalanx of the second toe.