sb/ke/nl/rg.
Date : 00.00.00

Name of the Patient : Abc Xyz A. Sukhlmn / M / 18 yrs.
Referred by : Dr. Abc Xyzrekh.
Examination : M.R.I. of the Left Knee Joint.

CLINICAL PROFILE :

C/O pain in the left knee joint with swelling since 15-20 days.

EXAMINATION :

M.R.I of the distal left femur including the knee joint was performed using the following parameters :

8 mm thick T1 Weighted and T2 Weighted axial images.

4 mm thick T1 Weighted and 5 mm thick GRASS sagittal images.

5 mm thick T1 Weighted and STIR coronal images.

OBSERVATION :

There is an ill-defined, hypointense signal on the T1 Weighted images involving the distal fourth of the shaft of the left femur including the distal femoral epiphysis. This lesion appears hyperintense on the T2 Weighted, STIR and the GRASS images. The superior margin of the lesion is about 14.0 cms from the distal margin of the left knee joint. There is a sharp zone of transition between the normal and the abnormal marrow signal.

There is evidence of periosteal elevation with an intermediate signal intensity soft tissue lesion on T1 Weighted images predominantly along the anterior, medial and the posterior margins of the distal left femur. This lesion also appears hyperintense on the T2 Weighted, STIR and GRASS images. Erosion of the cortex is noted in some places. The muscles around the distal left femur are displaced around the soft tissue lesion. The fat planes around the mass lesion and the visualized muscles are however well-identified. The left popliteal vessels are also displaced posteriorly. No vascular encasement is noted.
..2/.







Probable involvement of the femoral attachment of the anterior cruciate ligament is noted. The posterior cruciate ligament is unremarkable. The posterior horn of the medial meniscus of the left knee joint shows internal signal suggesting meniscal degeneration. The lateral meniscus is unremarkable.

IMPRESSION :

Altered signal in the distal fourth of the left femur (involving approximately the distal 14.0 cms) with periosteal elevation and soft tissue extension as described is not specific for a single etiology. Osteogenic sarcoma is a likely possibility. An infective process cannot be entirely ruled out.