A 38-year-old woman presented in 2005 with a fatty swelling over the dorsum of her left foot and was subsequently referred to our institution following initial biopsy for further management. MRI was performed before and after surgery. This demonstrated an ill-defined lesion confined to the subcutaneous tissues on the dorsum of the foot with heterogeneous intermediate and high T1 and T2 signal suggesting a complex mixture of fat and fibrous elements. The lesion recurred following initial surgery in the lateral aspect of the hind foot and along the lateral aspect of the ankle. It demonstrated extremely high signal on T2 fat-saturated sequences along the fibrous elements of the lesion and concentrated in a layer just deep to the dermis, which was mirrored on post-contrast images. A histopathological diagnosis of haemosiderotic fibrohistiocytic lipomatous lesion/tumour (HFLL/T) was made. This is a recently described and rare entity that occurs typically in the subcutaneous tissues of the foot or ankle of middle-aged women. To our knowledge this is the first description of the imaging findings in this lesion.

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Magnetic resonance imaging (MRI) plays a central role in the modern imaging of musculoskeletal disorders, due to its ability to produce multiplanar images and characterise soft tissues accurately. However, computed tomography (CT) still has an important role to play, not merely as an alternative to MRI, but as being the preferred imaging investigation in some situations. This article briefly reviews the history of CT technology, the technical factors involved and a number of current applications, as well as looking at future areas where CT may be employed. The advent of ever-increasing numbers of rows of detectors has opened up more possible uses for CT technology. However, diagnostic images may be obtained from CT systems with four rows of detectors or more, and their ability to produce near isotropic voxels and therefore multiplanar reformats.

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Paediatric penetrating chest trauma is common in conflict, but rarely seen in peacetime. We describe the successful hospital management of a five year old female civilian casualty with life threatening penetrating thoracic trauma caused by a fragment from an explosive device.