ke/hs/nl/nl
Name of the Patient : Abc Xyz Sanlmn / M / 32 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Left Arm.
CLINICAL PROFILE :
C/O pain and swelling over the posterior aspect of the left upper arm, with fever on and off.
EXAMINATION :
M.R.I of the left arm was performed using the following parameters :
4 mm thick T1 Weighted, GRASS (with fat saturation) and T2 Weighted (with fat saturation) coronal images.
4 mm thick T1 Weighted and STIR sagittal images.
6 mm thick T1 Weighted and T2 Weighted (with fat saturation) axial images.
The site of pain has been marked with the help of Vitamin E capsules.
OBSERVATION :
There is replacement of the normal marrow of the upper shaft (upper diaphysis) of the left humerus by hypointense areas on the T1 Weighted images. These are seen to turn hyperintense on the T2 Weighted, STIR and GRASS images. There is slight thickening of the cortex in that region with minimal periosteal reaction. Endosteal irregularity is also seen. Hyperintense signal is also noted in the adjacent soft tissues (biceps, brachialis and triceps brachii) on the T2 Weighted and STIR images. There is a fairly well-defined zone of transition between the normal and abnormal marrow.
The neurovascular bundle is unremarkable. The visualized left shoulder joint per se is unremarkable.
IMPRESSION :
Altered signal in the upper shaft (upper diaphysis) of the left humerus as described is not specific for a single diagnosis.
The differential diagnosis would include :
1. Osteomyelitis.
2. Neoplasia like Ewings sarcoma.