Date : 00.00.00
Name of the Patient : Abc Xyzh Phlmn / M / 2 1/2 yrs.
Referred by : Dr. Abc Xyzgrankar.
Examination : M.R.I. of the Left Thigh.
CLINICAL PROFILE :
C/O inability to bend the left leg with pain and swelling over the left femur since 20 days.
M.R.I. of the left thigh was performed using the following parameters :
7 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.
5 mm thick T1 Weighted and T2 Weighted coronal images.
5 mm thick T1 Weighted and STIR sagittal images.
There is evidence of a well-defined space-occupying lesion antero-medial to the left femoral shaft. This lesion is hypointense with a hyperintense rim on the T1 Weighted images and turns hyperintense with a hypointense rim on the T2 Weighted and STIR images. The vastus intermedius and medialis muscles cannot be identified separately from this lesion. Edema is seen adjacent to this lesion. The superior pole of this lesion is approximately 5.0 cms from the hip joint and the inferior pole is approximately 4.0 cms from the knee joint.
There is erosion of the medial femoral cortex with scalloping. The proximal metaphysis and upper diaphysis of the left femur shows a hypointense signal on the T1 Weighted images which turns hyperintense on the T2 Weighted and STIR images. The endosteum is also irregular and slightly thickened.
The visualized right thigh is unremarkable.
The MRI features are suggestive of a space-occupying lesion within the left thigh measuring approximately 3.0 x 4.5 x 11.0 cms with signal changes in the left femur. This most likely represents osteomyelitis with abscess formation.
The possibility of this being a neoplastic process (like Ewings sarcoma) though less likely cannot be entirely excluded.