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sb/hs/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyzai Plmn / M / 67 yrs.
Referred by : Dr. Abc Xyzndalia.
Examination : M.R.I. of the Left Leg.

CLINICAL PROFILE :

C/O pain and swelling over the lower end of shin of the left tibia since 10 days.
Past H/O tuberculosis in the left knee joint 25 years ago for which patient received AKT and was operated for the same.

EXAMINATION :

M.R.I. of the left leg was performed using the following parameters :

4 mm thick T1 Weighted and GRASS sagittal images.

4 mm thick T1 Weighted and STIR coronal images.

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

OBSERVATION :

There is evidence of an ill-defined, hyperintense signal on the GRASS, T2 Weighted and STIR images in the diaphysis of the distal left tibia. This lesion appears iso to slightly hypointense to normal marrow on the T1 Weighted images. This lesion extends from about 5.0 cms proximal to the distal end of the left tibia and extends for a distance of about 11.0 cms proximally. No obvious break in the cortex of the left tibia is noted at the site of the lesion though minimal periosteal elevation is noted at the site of the lesion.

There is a hypointense signal on the T1 Weighted images in the subcutaneous fat along the medial and posterior margin of the distal left tibia. This signal appears hyperintense on the T2 Weighted and STIR images and represents subcutaneous edema.
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The fat planes in the anterior and posterior compartments of the left leg are unremarkable. No obvious vascular encasement is noted.

The visualized left fibula appears unremarkable.

The visualized left knee joint shows evidence of severe osteoarthritic changes (post-operative status).

IMPRESSION :

Altered signal in the distal shaft of the left tibia
with extensions as described is not specific for a single etiology. This most likely represents an infective/inflammatory osteitis/osteomyelitis. Subcutaneous edema is noted in the distal left leg. Severe osteoarthritic changes are noted in the visualized left knee joint (post-operative status).

Possibility of the above described lesion representing a neoplasm cannot be entirely excluded.

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