sb/hs/rg/nl
Name of the Patient : Abc Xyzlmn / M / 48 yrs.
Referred by : Dr. Abc Xyz Shah.
Examination : M.R.I. of the Pelvis.
CLINICAL PROFILE :
C/O pain in the right groin since 3-4 months.
On AKT since 00.00.00.
EXAMINATION :
M.R.I of the pelvis was performed using the following parameters:
4 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.
5 mm thick T1 Weighted and 4 mm thick STIR coronal images.
OBSERVATION :
The medial half of the superior pubic rami on either side show an ill-defined, hypointense signal on the T1 Weighted images which appears hyperintense on the STIR and T2 Weighted images. Involvement of the symphysis pubis per se is also noted.
There is seen an ill-defined, hyperintense signal on the T2 Weighted and STIR images in the right sided obturator externus and pectineus muscles and minimally in the adductor magnus muscle at its origin. This signal appears nearly isointense to the normal muscles on the T1 Weighted images. Within the right obturator externus muscle, there is a well-marginated hypointense lesion on the T1 Weighted images which appears hyperintense on the T2 Weighted and STIR images and would represent a cystic/ necrotic area. Slight effacement of the fat planes in that region is noted.
An enlarged, right external iliac lymphnode is noted along the right lateral pelvic wall with a maximum antero-posterior dimension of 2.0 cms in the axial plane (scans 103.2 & 104.2). Minimal fluid is noted in the hip joints on either side. The femoral heads and sacro-iliac joints are otherwise unremarkable on either side.
..2/.
IMPRESSION :
Altered signal in the medial half of the superior pubic rami on either side with involvement of the symphysis pubis per se most likely represents osteitis. Focal lesion in the right obturator externus muscle may represent an abscess. Altered signal in the muscles in the right groin as described may suggest inflammatory changes (myositis).
An enlarged right external iliac lymphnode is also noted.
Tuberculosis may be considered as a likely etiology. The possibility of this being a neoplasm is less likely.