Objective: The purpose of this case study is to describe the role of sonographic examination in the initial evaluation of an angioleiomyoma and to discuss the characteristic findings associated with this soft tissue mass. Clinical Features: A 52-year-old woman presented with a large, tender, erythematous mass on the anterolateral aspect of her right knee. Sonographic examination revealed a highly vascular mass within the subcutaneous tissues. Differential considerations included benign soft tissues masses such as angioleiomyoma and hemangioma. Intervention and Outcomes: Surgical consultation was recommended. Excisional biopsy was performed. Histopathological examination confirmed the diagnosis of angioleiomyoma. Conclusion: Although ultrasonographic findings of a superficial soft tissue mass may be nonspecific, when a highly vascular, well-defined, slow-growing mass is present, angioleiomyoma should be included in the differential diagnosis.

We emphasize the limitations of radiography in the diagnosis of this fracture. To our knowledge, this is the first case to describe the use of US in the diagnosis of an isolated trapezoid fracture.

This case demonstrated a rare aggressive appearance of polyostotic fibrous dysplasia located in the left innominate and the left proximal femur that prompted a diagnostic imaging workup and biopsy for suspected skeletal malignancy. These lesions may require careful evaluation by an experienced team of physicians, radiologists, and pathologists to ensure proper diagnosis and treatment.