sb/ke/nl/nl
Date : 00.00.00

Name of the Patient : Abc Xyzal Plmn / M / 5 yrs.
Referred by : Dr. Abc Xyzwhale.
Examination : M.R.I. of Both Hips.

CLINICAL PROFILE :

C/O pain and swelling over the left hip joint with inability to walk since 2 months.
H/O fall prior to this.

EXAMINATION :

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

4 mm thick T1 Weighted and STIR coronal images.

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

5 mm thick T1 Weighted sagittal images.

OBSERVATION :

There is seen a fairly large, approximately 6.0 x 6.0 x 7.0 cms sized, well marginated, expansile, heterogeneous signal intensity mass lesion in the proximal metaphysis of the left femur. This lesion is iso to hyperintense to the normal muscle on the T1 Weighted images and appears heterogeneously hyperintense on the T2 Weighted and STIR images. Multiple, fluid-fluid levels are noted within this lesion. Hyperintense signal on the T1 Weighted images, within this lesion, in some places, may represent haemorrhage/high protein content fluid. Periosteal reaction is noted around the left femur just distal to this lesion for a distance of about 4.5 cms. The zone of transition between the mass lesion and the normal marrow appears sharp. The muscles and the subcutaneous fat around the mass lesion in the proximal left thigh show a hyperintense signal on the T2 Weighted and STIR images may represent soft tissue edema. There is a small left hip joint effusion noted. There is no vascular encasement identified.



There is no definite involvement of the left hip joint per se. The left acetabulum and the epiphysis of the left femoral head are unremarkable.

The visualized right hip joint appears normal.

IMPRESSION :

A fairly large, approximately 6.0 x 6.0 x 7.0 cms sized, well marginated, expansile, mass lesion in the proximal metaphysis of the left femur as described is not specific for a single etiology. Multiple fluid-fluid levels within the lesion favours the diagnosis of an aneurysmal bone cyst. Giant cell tumor may be considered as a differential diagnosis.

The possibility of this being a neoplastic process like an osteogenic sarcoma cannot be entirely ruled out, though less likely.