Figure 1

MRI of the left knee prior and post curettage and antifungal therapy. Figure 1a: voluminous neoformation (arrow) with expansive character, inhomogeneous signal intensity and polycyclic contours, extending longitudinally for about 9 cm, infiltrating the soft tissues adjacent to the distal diaphysis and the metaphysis of the femur on the left. The mass has multiple cistic-like areas compatible with signs of intralesional necrosis and determines colliquative loosening and dislocation of the periosteal membrane that appears broadly interrupted. No significant erosion of the cortical bone and cancellous bone adjacent to where we except a focal thinning of the cortex. No injury to the remaining of femoral bone. The muscular structures, in particular the vastus medialis muscle and the biceps femoris, have altered perilesional signal intensity and appear displaced and compressed, without a safe plane of cleavage with the injury. Figure1b: almost complete resolution of disease, particularly in the middle third of the distal femur; mild edema of the soft tissues and muscular fibers (arrow).