Decubital ischemic fasciitis.

A 77-year-old immobilized woman presented with a hard, palpable and fixed mass over the greater trochanter. Subsequent Magnetic Resonance Imaging (MRI) revealed a subcutaneous mass lesion abutting the iliotibial band. On T1-weighted images (WI), the lesion was isointense to muscle (white arrow), with a central focus of high signal intensity (SI) (Fig. A, axial T1-WI). Fat suppressed (FS) T2-WI showed predominantly hyperintense signal (black arrowheads) with intralesional foci of low SI, adjacent to the right greater trochanter (white asterisk) (Fig. B, axial FS T2-WI). After intravenous administration of gadolinium contrast, marked enhancement was seen with small areas of non enhancement, in keeping with necrotic foci (white arrow) (Fig. C, coronal contrast-enhanced FS T1-WI.). Neither invasion of the gluteus muscles nor the bone marrow of the greater trochanter was seen. Solely based on the MRI findings, malignancy could not be excluded. Therefore, wide surgical resection of the lesion was performed. Histological examination revealed the diagnosis of ischemic fasciitis, with a central hypo cellular area surrounded by a fibroblastic (white asterisk) and vascular proliferating outer zone (Fig. D).