sb/ke/nl/rg.
Date : 00.00.00
Name of the Patient : Abc Xyzt V. lmn / M / 13 yrs.
Referred by : Dr. Abc Xyzar.
Examination : M.R.I. of the Left Elbow.
CLINICAL PROFILE :
C/O pain and swelling over the left elbow region since 1 month.
H/O fever.
EXAMINATION :
M.R.I of the left elbow was performed using the following parameters :
4 mm thick T1 Weighted and STIR coronal images.
4 mm thick T1 Weighted and GRASS sagittal images.
5 mm thick T1 Weighted and T2 Weighted with fat saturation axial images.
After administration of contrast, the following parameters were used :
4 mm thick T1 Weighted sagittal images (with fat saturation).
4 mm thick T1 Weighted coronal images.
5 mm thick T1 Weighted axial images (with fat saturation).
OBSERVATION :
There is seen an ill-defined, hypointense signal on the T1 Weighted images involving the proximal end of the ulna bone, specifically the coronoid process and part of the proximal shaft of the ulna. This lesion appears hyperintense on the T2 Weighted images. There is erosion of the tip of the coronoid process with periosteal elevation of the proximal shaft of the ulna. The ossification centre of the olecranon process is well identified separately. Similar altered signal is also seen in the trochlea and the capitellum. ..2/.
The rest of the distal end of the humerus and the proximal end of radius appear unremarkable, although the proximal ulna joint seems to be involved.
There is seen a heterogeneous signal intensity soft tissue lesion around the left elbow joint, which is slightly hyperintense to normal muscle on the T1 Weighted images and appears more hyperintense on the T2 Weighted images. Loculated fluid is noted around the left elbow joint.
The visualized muscles and tendons around the left elbow joint are displaced by the soft tissue mass lesion.
After administration of contrast, there is intense enhancement of the soft tissue lesion around the left elbow joint, sparing the fluid/necrotic areas.
Patchy enhancement is noted in the proximal end of the ulna and probably also in the distal end of the left humerus.
IMPRESSION :
Altered signal in the proximal end of the left ulna bone, trochlea and capitellum as described with erosion of the coronoid process, most likely is infective in etiology. Soft tissue around the left elbow joint may represent synovial thickening. Loculated fluid is also noted around the left elbow joint.