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Edwin Chu, M.D., is a board-certified, fellowship-trained radiologist. Dr. Chu completed medical school at The University of Texas at San Antonio and his radiology residency at The University of Pittsburgh Medical Center. Dr. Chu also completed his fellowship in Musculoskeletal Imaging at the University of California at San Francisco.

20-year-old Female with Chronic Dorsal Foot Pain

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- Usually occult until late adolescence or early adulthood
- Most common presentation: joint contracture or pain
- Usually affects only one limb
- Predilection for long bones of the limbs, hands, and feet


- Manifests as periosteal cortical thickening, thick undulating ridges of bone
- Demonstrates dripping wax appearance or flowing candle wax appearance
- Affected bones on this case: 2nd/3rd metatarsals and phalanges, cuneiforms, calcaneus, talus, and partially visualized distal fibula


- Benign soft-tissue tumor
- Classically located in the subscapular or infrascapular region, deep to the serratus anterior and latissimus dorsi musculature
- Can be bilateral
- Most common in elderly women
- Thought to result from recurrent friction between inferior scapula and posterior chest wall



- Similar attenuation and intensity to adjacent skeletal muscle
- Can demonstrate low level, heterogeneous enhancement on MR
- Can demonstrate mild to moderate FDG uptake on PET imaging


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20-year-old female with chronic dorsal foot pain. What most likely represents the imaging finding? ​

Image IQ Quiz: 20-Year-Old Female with Chronic Foot Pain