sb/ke/rg/nl
Date : 00.00.00
Name of the Patient : Abc Xyzrlal lmn / M / 52 yrs.
Referred by : Dr. Abc Xyzhrivastav.
Examination : M.R.I. of Both Hips.
CLINICAL PROFILE :
C/O backache since 2 1/2 months.
EXAMINATION :
M.R.I of both hips and iliac bones was performed using the following parameters :
7 mm thick T1 Weighted and STIR coronal images.
8 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.
The lumbar spine was screened with 5 mm thick T1 Weighted sagittal images.
OBSERVATION :
There is seen an expansile lesion in the ischial bone on the left side. This lesion is of intermediate signal on the T1 Weighted images and appears hyperintense on the T2 Weighted images. Similar signal intensity lesions are also noted in the left iliac wing, roof of the left acetabulum, left superior pubic ramus, proximally, right iliac and sacral bones adjacent to the right sacro-iliac joint, right ischial tuberosity, proximal shaft of the right femur and in the neck of the left femur.
Mild bulge of the left obturator internus muscle, medially is noted. The left sided adductor muscles show an ill-defined hyperintense signal on the T2 Weighted and STIR images. The muscles around the left hip joint appear atrophied as compared to the right.
A small left hip joint effusion is noted.
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The visualized right hip joint per se is unremarkable.
There are no abnormally enlarged lymphnodes in the visualized pelvis.
Screening images of the lumbo-sacral spine reveal Grade II spondylolisthesis of the L5 over the S1 vertebra with probable spondylolysis at L5. Altered signal is noted in the D10, D11, L2 and L3 vertebral bodies.
IMPRESSION :
An expansile lesion in the ischial bone on the left side with altered signal visualized bones of the pelvis, femur and the dorso-lumbo-sacral spine as described is not specific for a single etiology. Metastatic deposits is a likely possibility.
Round cell tumor can be considered as a differential diagnosis.
An infective etiology is less likely.