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Figure 1. A 22-year-old woman with a family history of hypercholesterolemia had had a soft-tissue swelling on the back of her left ankle for several years. Examination revealed a fusiform swelling of the Achilles' tendon. The serum cholesterol concentration was 352 mg per deciliter (9.1 mmol per liter), and triglyceride concentrations were normal. Physical examination revealed no other manifestations of a lipid disorder. Sagittal proton-weighted magnetic resonance imaging showed a homogeneously enlarged Achilles' tendon (arrow in Panel A) with increased signal intensity caused by xanthomatous material and parallel striation of low signal intensity caused by the collagen fibers of . . . [Full Text of this Article] |