An x-ray shows that there is a lesion in the mid tibia which corresponds with the soft tissue abnormality noted. It appears that there is a series of openings in the tibial cortex at the location of the lesion, the largest of which is less than a centimeter in length and perhaps 0.5-cm in width. There are couple of smaller nearby openings as well. Overall the size of the lesion represents a little bit more than half the diameter of the shaft of the bone. There is no periosteal reaction. There is no matrix mineralization or other visible abnormality on x-ray. The MRI shows what appears to be a vascular anomaly. The lesion can be clearly seen crossing the tibial cortex, line both anterior and the tibial cortex perhaps underneath the periosteum, transgressing the cortex, and then lying within the intramedullary space. It has the globular appearance of a possible vein, and it connects to an elongated vascular appearing structure that exits proximally through a nutrient foramen in the posterior tibial cortex and joins the vascular elements in the soft tissues behind the tibia. The size of the vessel behind the tibia is slightly enlarged as well.