Date : 00.00.0000

Name of the Patient : Abc Xyzsh Kantlmn / M / 9 yrs.
Referred by : Dr. Abc Xyzarmar.
Examination : M.R.I. of the Sacro-iliac Joints.

CLINICAL PROFILE :

C/O fever and pain in the right hip joint.

EXAMINATION :

M.R.I of the sacro-iliac joints was performed using the following parameters :

5 and 7 mm thick T1 Weighted and 5 and 8 mm thick T2 Weighted (with and without fat saturation) axial images.
5 mm thick T1 Weighted and STIR coronal images.
The lumbar spine was scanned with 4 mm thick T1 Weighted and T2 Weighted sagittal images.

OBSERVATION :

There is an ill-defined, hyperintense signal on the T2 Weighted and STIR images in the sacral and iliac bones adjacent to the right sacro-iliac joint. This signal appears hypointense to normal marrow signal on the T1 Weighted images. The right sacro-iliac joint space per se also shows a hyperintense signal on the T2 Weighted and STIR images.

There is an intermediate signal intensity soft tissue lesion on the T1 Weighted images in the posterior paraspinal muscles on the right in the region of the right sacro-iliac joint. This lesion appears hyperintense on the T2 Weighted and STIR images and most likely represents an abscess. Diffuse altered signal is noted in the right gluteal region, in the right half of the pelvis, involving the right obturator internus muscle and tracking through the right sciatic foramen. This signal change may suggest myositis with generalized inflammatory changes in the fat planes. Resultant mild deviation of the rectum to the left is noted.

The visualized hip joints, per se and the left sacro-iliac joint are unremarkable, though signal change is noted in the roof of the right acetabulum.

Hyperintense signal on the STIR images is seen in the left gluteal muscle (? related to previous injection).

Screening images of the lumbar spine do not reveal any significant feature of note.

IMPRESSION :

Altered signal in the sacral and iliac bones adjacent to the right sacro-iliac joint with soft tissue changes as described, most likely represents an infective sacro-ilitis with myositis and inflammatory changes in the right gluteal region and right half of the pelvis. A small abscess is noted in the right posterior paraspinal soft tissues.

The possibility of this representing a neoplasm seems less likely.