Dorsal Wall Ultrasound
Technique:
Real-time ultrasound examination of the posterior lumbar dorsal wall was performed using a
high-frequency linear transducer (7–12 MHz), supplemented with a low-frequency curvilinear probe
where required for deeper evaluation.
Systematic assessment of the paraspinal region was performed in longitudinal and transverse planes.
Skin, subcutaneous tissue, paraspinal muscle layers, and deeper soft tissue structures were evaluated.
Clinical indication:
Suspected soft tissue lesion
Skin & Subcutaneous Tissue: Skin thickness appears normal. Subcutaneous tissue shows normal echotexture with no edema or collection.
Muscle Layers:
In the posterior lumbar paraspinal region, a well-defined hyperechoic lesion is noted within the
deep paraspinal muscle plane (likely involving erector spinae / multifidus group),
measuring approximately 4.3 × 2.0 cm.
The lesion demonstrates homogeneous fatty echotexture with fine internal linear echogenic striations,
oriented parallel to muscle fibers.
No surrounding muscle invasion or architectural distortion is identified.
Fascial Planes:
Fascial planes appear preserved with no evidence of disruption or fluid tracking.
Soft Tissue:
No additional focal soft tissue mass, cystic lesion, or abscess is seen.
Vascularity:
No internal vascularity is noted within the lesion on Doppler evaluation.
Impression:
Well-defined intramuscular hyperechoic lesion within the deep paraspinal muscles,
demonstrating characteristic sonographic features of a lipoma.
Features are suggestive of deep paraspinal intramuscular lipoma.
Recommendation: Clinical correlation is advised. MRI may be considered for further evaluation, particularly to assess depth and extent. Follow-up is recommended if symptomatic or showing interval increase in size.
Kindly Note:
Limitations / Technical Factors:
Ultrasound evaluation is limited for deep-seated lesions and bony structures.
Clinical correlation and further imaging (MRI / CT) may be required depending on clinical suspicion.
• This report is not valid for medico-legal purposes.
End of Case Study
You have reached the end of this Deep Paraspinal Intramuscular Lipoma – Back Lump (Dorsal Wall Ultrasound Case Study).
This evaluation was performed using Ultrasonography (USG), enabling real-time assessment of deep musculoskeletal soft tissue structures.
Content is intended for educational, training, and clinical reference purposes only.
Declaration:
I, R. K. Mouj, declare that the material presented in this case study titled
“Deep Paraspinal Intramuscular Lipoma – Dorsal Wall (Back Lump) on Ultrasonography (USG)”
has been prepared solely for educational and academic purposes.
The findings demonstrate a well-defined, hyperechoic lesion located within the
deep paraspinal muscle plane (erector spinae / multifidus group) in the
posterior lumbar region, consistent with an intramuscular lipoma.
The lesion shows homogeneous fatty echotexture with fine internal linear striations,
oriented parallel to muscle fibers, with absence of internal vascularity on Doppler imaging.
No surrounding soft tissue infiltration or aggressive features are identified.
Ultrasonography is a useful, non-invasive modality for evaluating soft tissue masses;
however, assessment of deep lesions may be limited, and further imaging such as MRI may be required.
These findings are intended for educational and demonstration purposes only.
Definitive diagnosis and management require clinical correlation and appropriate medical consultation.
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