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ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc XyzYerlmn / M / 26 yrs.
Referred by : Dr. Abc Xyzle.
Examination : M.R.I. of the Left Knee Joint.

CLINICAL PROFILE :

C/O pain and swelling over the left knee joint since 1 month.
H/O being hit by a heavy object.

EXAMINATION :

M.R.I of the left knee joint and proximal left leg was performed using the following parameters :

4 mm thick T1 Weighted and T2 Weighted images (with fat saturation) sagittal images.

4 mm thick T1 Weighted coronal images.

7 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.

OBSERVATION :

There is an ill-defined, hypointense area on the T1 Weighted images replacing the normal marrow of the lateral aspect of the tibial plateau and the proximal shaft of the tibia for approximately 16 cms from the left knee joint, inferiorly. This is seen to turn hyperintense on the T2 Weighted and Gradient images. There is a clear zone of transition between the lesion and the normal marrow. There is a break along the antero-lateral cortex (scan 102.4) of the proximal left tibia with slight thinning of the lateral aspect of the cortex. Probable break in the cortex of the tibia, anteriorly, near the tibial tubercle is also noted.

Large ill-defined mass lesion is seen within the anterior compartment of the proximal left leg, which measures approximately 5.2 x 4.5 x 3.5 cms. This lesion is hypointense to muscle on the T1 Weighted images and turns hyperintense on the T2 Weighted and Gradient images. Multiple septae are seen within this lesion.
..2/.


- 2 - Scan-00000


The visualized left knee joint per se is unremarkable. The rest of the visualized left tibia appears unremarkable. No vascular anomaly is identified on this study.

IMPRESSION :

Altered signal in the marrow of the lateral aspect of the tibial plateau and the proximal shaft of the left tibia, approximately 16 cms from the left knee joint, inferiorly, with a large, probably cystic mass lesion in the anterior compartment of the left leg, proximally, measuring approximately 5.2 x 4.5 x 3.5 cms as described is not specific for a single etiology. Chronic osteomyelitis/sclerosing osteomyelitis with a collection is a likely possibility.

The possibility of this being a neoplastic process like an osteosarcoma/round cell tumor may be considered as a differential diagnosis, though less likely.


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