Date : 00.00.00
Name of the Patient : Abc Xyzee Klmn / F / 9 yrs.
Referred by : Dr. Abc Xyzshi.
Examination : M.R.I. of the S. I. Joints.
CLINICAL PROFILE :
H/O pyoderma. Received intramuscular injection. Developed pain in the left gluteal region with restriction of movement of the LLE.
M.R.I of the S. I. joints was performed using the following parameters :
6 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.
3 mm thick T1 Weighted and STIR coronal images.
5 mm thick T2 Weighted sagittal images through the L. S. Spine.
There is an ill-defined hypointense signal on the T1 Weighted images involving the marrow of the left iliac bone adjacent to the left sacro-iliac joint. This lesion appears hyperintense on the T2 Weighted and STIR images. No obvious cortical erosion or bone destruction is noted. The sacral component of the left sacro-iliac joint and the left sacro-iliac joint per se are unremarkable.
There is seen an intermediate signal intensity soft tissue lesion on the T1 Weighted images deep to the left gluteus maximus and medius muscles in close, relation to the left iliac bone. This lesion appears hyperintense on the T2 Weighted and STIR images. Similar lesion is seen deep to the left ilio-psoas muscle, along the left lateral pelvic wall and involving the left piriformis muscle.
The visualized right sacro-iliac joint and the hip joints on either side are unremarkable.
The screening images of the lumbo-sacral spine do not reveal any significant feature of note.
Altered signal in the left iliac bone adjacent to the left sacro-iliac joint as described is not specific for a single etiology. This most likely represents osteitis, in the given clinical setting. Soft tissue lesion deep to the left gluteal muscles and left ilio-psoas muscle in close relation to the left iliac bone and in the region of the left piriformis muscle may either represent a small inflammatory collection/granulation tissue, or may suggest myositis involving the gluteus muscles, iliacus muscle and the piriformis muscle.