Date : 00.00.00

Name of the Patient : Abc Xyzlal B. lmn / M / 68 yrs.
Referred by : Dr. Abc Xyzaubal.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

H/O fracture neck femur in November 0000.
C/O pain in the LLE with inability to walk since November 0000.
H/O left hip joint arthroplasty on 00.00.00 with subsequent traction. Infection at site of pin in the left knee joint.
Now C/O inability to walk.

EXAMINATION :

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

5 mm thick T1 Weighted and STIR coronal images.

7 mm thick T1 Weighted and T2 Weighted axial images.

SOME IMAGES SHOW PATIENT MOTION.

OBSERVATION :

There is evidence of excision of the head and neck of left femur. There is loss of normal contour of the left acetabulum. Superior migration of the left femur is noted with the greater trochanter lying about 5.5 cms inferior to the left iliac crest. There is seen an intermediate signal intensity lesion on the T1 Weighted images in the region of the left acetabulum, which appears hyperintense on the T2 Weighted images. This may represent fibrous/scar tissue, in the given clinical setting. Probable synovial thickening around the left acetabulum is noted.

The left iliac and pubic bones constituting the left acetabulum appear hypointense on the T1 Weighted images and hyperintense on the T2 Weighted and STIR images.


There is seen an ill-defined, hyperintense signal on the T2 Weighted and STIR images in the fat planes along the muscles around the left hip joint and in the visualized proximal left thigh (namely, the left obturator internus, obturator externus, biceps, semitendinous and vastus lateralis). Some of the muscles themselves seem to show altered signal. The muscles around the visualized hip joints on either side and in the visualized proximal thighs appear atrophied, more on the left side.

No obvious signal change is identified in the visualized left femur.

The visualized right hip joint and right femur are unremarkable.

IMPRESSION :

1. Post-operative status.

2. Altered signal intensity lesion in the region of the left acetabulum may represent fibrous tissue in the given clinical setting. Altered signal in the left iliac and pubic bones constituting the left acetabulum may also represent post-operative changes.

3. Altered signal along the fat planes around the muscles around the left hip joint and proximal left thigh suggest inflammatory changes/myositis, in the given clinical setting.

4. Atrophy of the muscles around both the hip joints and proximal thighs, more on the left side.