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sb/ke/rg/nl
Date : 00.00.0000

Name of the Patient : Abc Xyz. Slmn / F / 40 yrs.
Referred by : Dr. Abc Xyzoonawalla.
Examination : M.R.I. of the Both legs.

CLINICAL PROFILE :

C/O pain in the right knee downwards with swelling since 3 months.
Alleged H/O fall 4 years ago with injury to the right ankle.
H/O Blood cancer. On Rx since 8 years.

EXAMINATION :

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

5 mm thick T1 Weighted and Fast Scan (T2 *) sagittal images.

5 mm thick T1 Weighted and STIR coronal images.

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

OBSERVATION :

The marrow of the proximal third of the right tibia appears hypointense on the T1 Weighted images and hyperintense on the T2 Weighted images. Approximately, the proximal 14.0 cms of the right tibia is involved. There is a sharp zone of transition between the normal and abnormal marrow. The cortical margins around the tibial plateau appear ill-defined with extension of the lesion into the soft tissues around the proximal end of the right tibia. Minimal soft tissue is also noted in the right knee joint per se.

Similar signal intensity lesions are also noted in the right medial condyle in the diaphysis of the visualized right and left femur, visualized proximal shaft of the left tibia, left fibula and in the right patella. The right fibula appears normal.
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There is a small knee joint effusion noted.

There is no extension of the lesion in the left knee joint per se.

The patellae on either side are subluxated laterally with the knee joints in extension.

IMPRESSION :

Altered signal in the femur, tibia and patella on either side as described, is not specific for a single etiology.

A lymphoreticular disorder is a likely possibility.

Multiple metastasis may be considered as a differential diagnosis.
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