Date : 00.00.00
Name of the Patient : Abc XyzK. Shlmn / F / 15 yrs.
Referred by : Dr. Abc Xyzar.
Examination : M.R.I. of the Pelvis.
CLINICAL PROFILE :
C/O pain and swelling over the left hip region radiating forwards to the left upper thigh since 5-6 months with a limp.
H/O fall prior to this.
M.R.I of the pelvis was performed using the following parameters:
7 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.
7 mm thick T1 Weighted and STIR coronal images.
7 mm thick T1 Weighted sagittal images.
There is an ill-defined, hypointense signal on the T1 Weighted images involving the marrow of the left iliac, pubic and the ischial bones and probably of the ala of the sacrum on the left and the bodies of the first two sacral segments. This signal remains predominantly hypointense on the T2 Weighted and STIR images. Probable involvement of the left sacro-iliac joint per se is noted.
There is seen a fairly large intermediate signal intensity mass lesion on the T1 Weighted images within the left half of the pelvis and in the left gluteal region, on either side of the left iliac bone. This lesion turns heterogeneously hyperintense on
the T2 Weighted images and seems to be incontinuity through the left sciatic notch. The left gluteal muscles are displaced postero-laterally. The left ilio-psoas and the left pyriformis muscles are not well identified separately from the medial margin of the tumor. The left obturator internus muscle is displaced medially. The left iliac vessels, recto-sigmoid, urinary bladder and the uterus and its adnexae are displaced to the right of the midline. The fat plane between the recto-sigmoid, urinary bladder and the mass lesion however seems to be well identified. The left ischio-rectal fossa is effaced.
The supero-inferior extent of the lesion is from the level of the left iliac crest upto the left ischial tuberosity.
There is no obvious extension of the lesion into the left hip joint per se. The left femoral head and neck show normal signal. A small left hip joint effusion is noted.
The fat planes in the proximal left thigh show a hyperintense signal on the T2 Weighted and STIR images which may represent soft tissue edema. The visualized right hip joint and the pelvic bones on the right are unremarkable.
Altered signal of the left iliac, pubic and the ischial bones and probably of the ala of the sacrum on the left and the bodies of the first two sacral segments with soft tissue lesion in the left half of the pelvis and the left gluteal region as described is not specific for a single etiology. This most likely represents a primary bone neoplasm. Osteogenic sarcoma, chondrosarcoma or round cell tumors should be considered as differential diagnosis.