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Date : 00.00.00

Name of the Patient : Abc Xyz Purlmn / M / 31 yrs.
Referred by : Dr. Abc Xyzarucha.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain in the right hip region on movement with inability to lift the RLE.
H/O Pulmonary kochs since 1 month. On AKT since then.

EXAMINATION :

M.R.I of both hips was performed using the following parameters :

5 mm thick T1 Weighted and STIR coronal images.

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

OBSERVATION :

There is an ill-defined, hypointense signal on the T1 Weighted images in the roof of the right acetabulum. This lesion appears hyperintense on the T2 Weighted and STIR images. There is erosion of the lateral cortical margin of the roof of the right acetabulum with extension of the lesion into the soft tissues around the right hip joint. This soft tissue lesion is hypointense when compared to normal muscle on the T1 Weighted images and is hyperintense on the T2 Weighted images. This soft tissue lesion is deep to the right gluteus minimus muscle along the lateral margin of the right acetabulum and tracks down into the proximal right thigh along the lateral margin of the right psoas muscle and deep to the rectus femoris muscle. The supero-inferior extent of the lesion is about 12 cms. The muscles around the right hip joint appear atrophied when compared to the left. The right sided adductor muscle proximally near the pelvis show a diffuse hyperintense signal on the T2 Weighted images which may suggest an inflammatory change. A right hip joint effusion is noted. The right femoral head and proximal shaft are unremarkable.



Focal altered signal is also noted in the pubic component of the right acetabulum, left ischial tuberosity and in the sacral bone. Minimal altered signal is also noted in the left iliac bone adjacent to the left sacro-iliac joint. Suspicious compromise of the upper sacral foramina on the right is noted.

The visualized left hip joint per se is unremarkable.

Screening, T1 Weighted sagittal images of the lumbo-sacral spine reveal a predominance of the hematopoeitic marrow in the lumbar vertebrae.

IMPRESSION :

Altered signal in the roof of the right acetabulum, pubic component of the right acetabulum, left ischial tuberosity, in the sacrum and in the left iliac bone adjacent to the left sacro-iliac joint as described is not specific for a single etiology. This most likely represents multifocal tuberculosis, in view of the present H/O Pulmonary tuberculosis. Soft tissue along the lateral margin of the right acetabulum extending into the proximal right thigh, anteriorly most likely represents an abscess.


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