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Diagnosed With Arthritis, Lypoma, An Osseous Hemangioma In SI Joint. What Treatment Is Required?

Posted on Thu, 9 May 2013

Question: I was diagnosed with an Osseous Hemangioma in my SI joint (3 cm by 2cm). Until now I have had a diagnosis of arthritis and a lypoma. I am not sure where to go next. The pain from this has been with me over a year and is not life-altering, but an annoyance. Do I go to a blood dr or a orthopedic dr? With patience and time, will this resolve itself?

Answered by Dr. Das Arindam (27 minutes later)

Hello,

Thank you for posting a query.

Look, from your description, it is evident that previous diagnosis was an osseous hemangioma and now, present diagnosis is a lipoma and arthritis.

For your information, lipoma cannot occur in bone. It is a soft tissue tumor. That means it occurs in the subcutaneous fatty tissue. Arthritis is a chronic inflammatory disease of joint with some degenerative changes.

So, from the above discussion, it is clear that these two condition cannot occur in one area. So, I think, you need to be evaluated more meticulously for the pain.

For the arthritis and osseous hemangioma you have to consult with an orthopedic surgeon. But, you have to consult with a general surgeon for the lipoma.

So, considering your present concern about the pain, you should consult with an orthopedic surgeon first for a detailed clinical examination and for ordering necessary investigations like CT scan or MRI study of the sacroiliac joint.

If the orthopedic surgeon founds that you need attention for the lipoma, he / she will guide you.

Lastly, you have to consult with an orthopedic surgeon first for the further management.

Hope this information suffices. Let me know, if you have anymore question.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Das Arindam (29 minutes later)

My most recent diagnosis came from an MRI on Tuesday. The diagnosis was changed from arthritis (diagnosis in XXXXXXX from CT Scan) to a lypoma (diagnosis in August from MRI) to now an osseous hemangioma (from MRI with contrast). I have now developed a small subcutaneous blood clot on my groin, too. It is about the size of a nickle, purplish in color and is very tender. Why am I getting these blood clots? Should I also see a blood specialist or in the least ask my GP to run a set of blood tests? I appreciate your time!

Answered by Dr. Das Arindam (8 minutes later)

Hello,

Thank you for writing back.

Look, osseous hemangioma is a benign lesion of bone, where the blood vessels are increased in number.

So, you have to consult with an orthopedic surgeon.

As the disease is associated with proliferation of blood vessels, it is common to have some blood clot in groin. It is not a blood disorder.

Just ask your general physician to order a coagulation profile. If the coagulation profile is absolutely normal, you do not need to consult a hematologist.

Hope, you have your answers.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Das Arindam (7 minutes later)

Thank you so much! I really feel better. That is the best info I have gotten in the past 11 months of treatment, office visits and tests :) Only one more question: What caused this? Trauma? (even though I do not remember any trauma to my groin or rear end, I guess it is possible) Any idea what the orthopedic surgeon will want to do for treatment? I just want to have an idea of the options available.

Answered by Dr. Das Arindam (24 minutes later)

Hello,

Thank you for writing back.

Look, trauma is not a cause. Generally it is idiopathic in nature. That means its exact cause is not known.

Orthopedic surgeon will first examine you in details. Then, he / she will see the images like CT scan and MRI. After confirmation of diagnosis as an osseous hemangioma, the next line of management should be determined.

Usually, a painless hemangioma does not require any intervention. But, in your case, with painful conditions, surgical intervention is required. The nature of surgical intervention depends on presence or absence of other features. So, ultimate decision depends on the orthopedic surgeon.

So, consult with an orthopedic surgeon for further management.

Hope, you have your answers.

Regards.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Das Arindam (21 minutes later)

Thank you so much. I now have answers that I didn't have before. I am planning to call my GP Monday and ask for the coagulation profile, and my neurologist to ask for a referral to an orthopedic surgeon. I really appreciate your knowledgable and detailed advice. This is my first time using this service and I am glad I did.
XXXXXX

Answered by Dr. Das Arindam (16 minutes later)

Hello,

Thank you for writing back.

I am happy that you have found my information helpful.

You have planned correctly.

If you do not have any more question right now, you can close this discussion.

Rating and review given by you will be appreciated.

Regards.

Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar