ke/hs/nl/rg.
Name of the Patient : Abc Xyzh Dhunlmn / M / 15 yrs.
Referred by : Dr. Abc Xyzhrivastav.
Examination : M.R.I. of the Left Thigh.
CLINICAL PROFILE :
C/O swelling over the left thigh.
HP s/o osteogenic sarcoma.
EXAMINATION :
M.R.I of the left thigh was performed using the following parameters :
6 mm thick T1 Weighted sagittal images.
5 mm thick T1 Weighted and STIR coronal images.
8 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.
OBSERVATION :
There is destruction and replacement of the marrow by hypointense areas on the T1 Weighted images of the middle and lower one third of the left femur. There is an ill-defined zone of transition between the lesion and the normal marrow. This is seen to turn hyperintense on the T2 Weighted and STIR images. The cortex appears to be thickened with periosteal reaction. There is involvement of the vastus intermedius muscle which shows presence of hyper and hypointense signal on the T1 Weighted images and which are seen to turn hypo and hyperintense on the T2 Weighted images. The vastus intermedius muscle appears bulky and shows a hyperintense signal on the T2 Weighted and STIR images. There is displacement of the vastus medialis and lateralis muscles with their probable involvement. This lesion measures approximately 29.5 x 9.5 x 9.4 cms. The muscle of the adjacent posterior compartment of the left thigh appear to be displaced. There is probable involvement of the left knee joint.
..2/.
- 2 - Scan-00007
A hypointense lesion on the T1 Weighted images which turn hyperintense on the T2 Weighted and STIR images is seen in the medial condyle of the right femur. This is seen to have a hypointense rim on all the pulse sequences and may represent a medullary infarct.
IMPRESSION :
1. In a known C/O osteogenic sarcoma the MRI features are suggestive of a lesion involving the middle and lower one third of the left femur with marrow involvement, periosteal reaction and soft tissue involvement as described.
2. A probable medullary infarct (?? secondary) involving the medial femoral condyle on the right side.