granuloma annulare

Granuloma annulare is a benign idiopathic inflammatory disorder of the dermis, characterized by formation of dermal papules in young children.

Clinical presentation

Granuloma annulare most commonly seen in kids between 2-12 years old and usually it occurs in extremities. One typical location is pretibial when the lesion is subcutaneous. It has various clinical presentations:

  • three cutaneous forms
    • erythematous
    • perforating
    • generalized
  • one subcutaneous form: presenting as a soft tissue mass - subcutaneous granuloma annulare

Radiographic features

Plain radiograph

These have very little value. The only manifestation is non-specific increased density in the subcutaneous compartment without involvement of bone involvement or mineralization.

Ultrasound

Shows ill-defined solid mass that is hypoechoic to surrounding fat. It excludes a vascular of cystic lesion.

MRI
  • T1: ill-defined subcutaneous mass, isointense to muscle
  • T2: slightly hypointense signal intensity compared with fat, but may also show heterogeneous hyperintense signal
  • T1 C+: diffuse enhancement can be seen
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