Date : 00.00.00
Name of the Patient : Abc Xyz. Sonalmn / F / 13 yrs.
Referred by : Dr. Abc Xyzrekh.
Examination : M.R.I. of the Right Hip Joint & Right Femur.
CLINICAL PROFILE :
C/O pain and swelling over the right thigh since 1 month.
H/O pus aspiration from the right hip on 00.00.00.
M.R.I. of the right hip joint & right femur was performed using the following parameters :
5 mm thick T1 Weighted and 5 mm and 7 mm thick T2 Weighted (with fat saturation) axial images.
5 mm thick T1 Weighted and STIR coronal images.
5 mm thick proton density sagittal images.
There is seen an ill-defined, hypointense signal on the T1 Weighted images in the neck and proximal fourth of the shaft of the right femur. This lesion appears heterogeneously hyperintense on the T2 Weighted and STIR images. Periosteal elevation is noted along the medial margin of the proximal shaft of the right femur. The epiphysis of the right femoral head and of the greater trochanter appear to be spared.
The vastus intermediate and the vastus lateralis muscles show an ill-defined, hyperintense signal on the T2 Weighted and STIR images over their entire extent. The adductor muscles in the region of the right obturator foramen also show similar signal intensity change. A focal area of necrosis/cystic collection is noted within the above described muscle group. Fluid collection is also noted along the vastus lateralis muscle in the distal right thigh. The
subcutaneous fat along the anterior and lateral margins of the right thigh also show altered signal. Altered signal is also noted in the fat planes around the right gluteal muscles and along the lateral margin of the right obturator internus muscle. Evidence of surgical intervention is noted in the mid-segment of the right thigh (scans 102.17-18).
Fluid is seen within the right hip joint. The right acetabulum also shows altered signal (hypointense on the T1 Weighted images and hyperintense on the T2 Weighted and STIR images).
The muscles of the right thigh appear atrophied as compared to the left.
Altered signal in the proximal fourth of the right femur as described most likely represents osteomyelitis, in the given clinical setting. Diffuse altered signal, in the muscles of the right thigh as described with focal area of necrosis/cystic collection would represent myositis.
The possibility of the above described lesion representing a neoplasm seems less likely.