Date : 00.00.00
Name of the Patient : Abc Xyz Shlmn / F / 38 yrs.
Referred by : Dr. Abc Xyzdi.
Examination : M.R.I. of the Pelvis.
LINICAL PROFILE :
C/O backache radiating to the LLE since December 0000 which has increased since 2-3 days with fever.
M.R.I of the pelvis was performed using the following parameters :
6 mm thick T1 Weighted and T2 Weighted (fat saturation) axial images.
6 mm thick T1 Weighted and STIR coronal images.
The lumbo-sacral spine was scanned with 5 mm thick T1 Weighted sagittal images.
Irregularly defined areas of hypointensity on the T1 Weighted images which turn hyperintense on the T2 Weighted and STIR images are seen to involve the left sacral ala and the lower sacral bodies. This lesion is seen to occupy the spinal canal from the L5-S1 level downwards. Also seen is extension into the left paraspinal muscles from the L5 vertebral level downwards. There is extension of this pathologic process into the left piriformis muscle and left gluteal muscles with probable encasement of the left sciatic nerve. Also seen is probable involvement of the right coccygeus muscle and ischio femoral ligament on the left side. There is a well-defined lesion in the region of the right piriformis muscle which appears hypointense on the T1 Weighted images with a hyperintense rim and turns hyperintense on the T2 Weighted images with a hypointense rim and is most likely an abscess. There is also suspicious involvement of the right superior gemellus muscle.
Follicles are seen within both the ovaries.
The urinary bladder appears normal.
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The ischio-rectal fossae on either side appear normal.
There are no abnormally enlarged pelvic lymph nodes identified. No obvious vascular anomaly is noted. There is no free fluid in the pelvis.
Screening of the lumbar spine shows no feature of note.
The MRI features are suggestive of a pathologic process involving the sacrum and
the left piriformis muscle and left gluteus muscles as described. This most likely represents an infective process (? tuberculosis). A probable abscess is identified in the region of the left piriformis muscle.
The possibility of this being a neoplastic process is less likely.