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1. Klippel-Trenaunay syndrome

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Figure 64-1

Klippel-Trenaunay syndrome.

An orthoroentgenogram of a 15-year-old girl shows elongation and enlargement of the long bones of the right leg. There is marked prominence of the soft tissues of the right leg, due to vascular malformations.

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2. Klippel-Trenaunay syndrome

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Figure 64-2

Klippel-Trenaunay syndrome.

A, B. T1-weighted coronal MR images show soft tissue and osseous overgrowth in the left leg. There are multiple flow voids from dilated and tortuous veins, predominantly in the subcutaneous tissue.

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3. Hypoplastic primary lymphedema

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Figure 64-3

Hypoplastic primary lymphedema.

A, B. Anterior lymphoscintigraphy images of the lower legs of a 14-year-old girl were obtained 5 minutes (A) and 35 minutes (B) after subcutaneous injection of 99mTc sulfur colloid particles into the dorsal aspects of the feet. There is normal ascent of tracer in lymphatic vessels in the left lower leg. There is no discernible ascent on the right, with retention in the soft tissues of the included portion of the foot.

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4. Hemihyperplasia

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Figure 64-4

Hemihyperplasia.

A. A coronal T1-weighted MR image of an 11-year-old boy shows mild elongation of the right femur. B. Marked right-sided soft tissue overgrowth is visible on this T2-weighted fat-suppressed axial image.

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5. Hemihyperplasia

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Figure 64-5

Hemihyperplasia.

A. This 13-year-old girl has overgrowth of the bones and soft tissues of the right lower extremity (upright radiograph). B. There is also asymmetry of otherwise normal cerebral hemispheres (fluid-attenuated inversion recovery [FLAIR] MR image).

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6. Macrodystrophia lipomatosa

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Figure 64-6

Macrodystrophia lipomatosa.

Three different patients. A. There is overgrowth of the great toe of a 2-year-old child. The distal phalanx has a widened, mushroom shape. B. A radiograph of a 7-year-old child shows enlarged phalanges and soft tissues of the left second toe. C. There is involvement of the second and third toes of this 8-month-old infant.

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7. Macrodystrophia lipomatosa

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Figure 64-7

Macrodystrophia lipomatosa.

A, B. T1-weighted coronal MR images of a 1-year-old child. The ring finger is elongated. There is marked overgrowth of adipose tissue in the ring finger and, to a lesser extent, the fifth finger.

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