Date : 00.00.00
Name of the Patient : Abc Xyzray K. Yerulmn / M / 43 yrs.
Referred by : Dr. Abc Xyzrankar.
Examination : M.R.I. of Both Hips.
CLINICAL PROFILE :
C/O pain and swelling over the right gluteal region since 1 year.
M.R.I of both hips was performed using the following parameters :
8 mm thick T1 Weighted and STIR coronal images.
8 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.
8 mm thick T1 Weighted sagittal images.
There is replacement of the normal marrow of the right ischial tuberosity and posterior column of the right acetabulum by hypointense areas on the T1 Weighted images. These are seen to turn heterogeneously hyperintense on the T2 Weighted and STIR images. There is a break in the cortex with involvement of the obturator internus muscle which shows a subtle hyperintense signal on the T2 Weighted and STIR images. There is a large lesion within the fat planes inbetween the gluteus medius and maximus muscles which is hypointense to normal muscle on the T1 Weighted images and turns hyperintense on the T2 Weighted and STIR images. This may represent an abscess. This lesion is seen to extend upto the subcutaneous region laterally. This lesion is seen to extend upto the right iliac crest and to just below the lesser trochanter. The greater trochanter of theright femur is also involved. The gluteus maximus muscle also shows subtle hyperintense signal on the T2 Weighted and STIR images suggestive of its involvement. The musculature around the right hip joint appears bulky.
The left hip joint is unremarkable. There are no abnormally enlarged lymph nodes or free fluid in the pelvis.
Small (subcentimeter) soft tissue lesions are noted in the anterior abdominal wall on the left and in the right lateral abdominal wall. These are of ? etiology, ?? nerve sheath tumors (scan 103.5).
The MRI features are suggestive of a large lesion which most likely represents an abscess in the right gluteal region with involvement of the right ischial tuberosity, posterior column of the right acetabulum and the greater trochanter of the right femur. This is most likely an infective process (? tuberculosis).
The possibility of this being a neoplastic process is less likely.