Date : 00.00.00
Name of the Patient : Abc Xyzayan Ylmn / M / 16 yrs.
Referred by : Dr. Abc Xyzrekh.
Examination : M.R.I. of the Right Knee Joint.
CLINICAL PROFILE :
C/O pain and swelling over the right knee joint since 10 months.
M.R.I of the right knee joint was performed using the following parameters :
4 mm thick T1 Weighted sagittal images.
5 mm thick T1 Weighted coronal images.
7 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.
7 mm thick T2 Weighted (with fat saturation) coronal images.
There is seen a defect along the postero-lateral wall of the distal right femur, in the metaphysis, with erosion of the cortex in that region. Ill-defined hypointense signal on the T1 Weighted images is noted in the marrow adjacent to this lesion. This marrow signal appears heterogeneously hyperintense on the T2 Weighted images.
There is an intermediate signal intensity soft tissue lesion on the T1 Weighted images along the posterior, lateral and anterior margins of the distal right femur, which appears hyperintense on the T2 Weighted images. This lesion appears deep to the vastus lateralis intermedius and medialis muscles which are displaced peripherally by the lesion. The vasti muscles in the distal segment of the right thigh however shows a hyperintense signal on
the T2 Weighted images, suggesting myositis. The biceps femoris muscle is displaced postero-laterally by the lesion and the popliteal vessels are displaced posteriorly. Extension of the soft tissue lesion into the suprapatellar bursa is also noted.
The supero-inferior extent of the above described lesion is about 13.0 cms from the knee joint space. There is however, no involvement of the knee joint space per se.
Defect in the postero-lateral margin of the distal end of the right femur, in its metaphysis, with soft tissue lesion around the distal end of the right femur as described is not specific for a single etiology. This most likely represents chronic osteomyelitis with an abscess around the distal right femur.
The possibility of a neoplasm like a perosteal sarcoma cannot be entirely ruled out, though less likely.