sb/ke/nl/nl







Name of the Patient : Abc Xyz Ganglmn / M / 17 yrs.
Referred by : Dr. Abc Xyzhari.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain in the right hip region with difficulty in walking.
MRI of June 0000 s/o Kochs. Received AKT upto September 0000.

EXAMINATION :

M.R.I of both hips was performed using the following parameters :

5 mm thick T1 Weighted and STIR coronal images.

5 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.

5 mm thick Proton density sagittal images.

OBSERVATION :

There is loss of normal contour of the right femoral head and decrease in the right hip joint space. The right femoral head shows spotty fatty marrow changes.

The articular cartilage overlying the right femoral head is not well identified. Marginal osteophytes are noted around the right hip joint.

There is an ill-defined, hyperintense signal on the T2 Weighted and STIR images in the neck and greater trochanter of the right femur and in the right acetabulum. This signal appears hypointense to the normal marrow signal on the T1 Weighted images. Similar signal intensity changes are noted in the right iliac bone adjacent to the right sacro-iliac joint in its midsegment and in the right ischial tuberosity.


There is a small, right hip joint effusion.

The muscles around the right hip joint are atrophied as compared to the left.

The visualized left hip joint is unremarkable.

Small, subcentimeter, inguinal lymph nodes are noted bilaterally, more on the right side.

IMPRESSION :

1. Altered signal in the neck and greater trochanter of the right femur, right acetabulum, right ischial tuberosity and in the iliac component of the right sacro-iliac joint in its midsegment, is not specific for a single etiology. These changes may represent multifocal tuberculosis, in the given clinical setting.

2. Decrease in the right hip joint space with altered contour of the right femoral head, marginal osteophytes around the right hip joint and ill-defined articular cartilage overlying the right femoral head may suggest secondary osteoarthritic changes.

3. Diffuse atrophy of the muscles around the right hip joint.

As compared to the previous MRI 00.00.0000, the right hip joint shows changes of secondary osteoarthritis with atrophy of the muscles around the right hip joint. Altered signal is noted in the neck and greater trochanter of the right femur, right ischial tuberosity and right iliac bone. There is slight decrease in the degree of right acetabular involvement.