sb/ke/rg/nl
Date : 00.00.00

Name of the Patient : Abc Xyzi B. Shlmn / F / 17 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Both hips.

CLINICAL PROFILE :

C/O backache radiating to the RLE since 15 days.
H/O tuberculous cervical lymphadenopathy detected in May 0000. On AKT.

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 (with fat saturation) images.

OBSERVATION :

There is an ill-defined hypointense signal on the T1 Weighted images in the neck and proximal shaft of the right femur. This lesion appears hyperintense on the T2 Weighted and STIR images. Similar signal change is noted in the iliac bones on either side, ala of the sacrum bilaterally, right ischial bone, roof of the right acetabulum and at the junction of the neck and proximal shaft of the left femur with minimal involvement of the lateral aspect of the right femoral head. The femoral heads on either side show normal contour. There is obliteration of the right sided first sacral foramen. Hyperintense signal is seen on the T2 Weighted and STIR images in the adductor group of muscles on the right side and the ilio-psoas muscle anterior to the upper shaft of the femur (se/im:102.18-20).
..2/.









>

A small right hip joint effusion is noted.

There is no definite involvement of the sacro-iliac joints per se on this study.

No obvious enlarged lymphnodes are noted in the visualized pelvis.

Slight decrease in the bulk of the muscles around the right hip joint is noted.

Hyperintense signal on the T2 Weighted and STIR images in the gluteal muscles bilaterally may be due to intramuscular injection.

T1 Weighted sagittal images of the lumbar spine reveal focal hypointense areas in the L3, L4 and L5 vertebral bodies.

IMPRESSION :

Altered signal in the head, neck and proximal shaft of the right femur, iliac bones on either side, ala of the sacrum bilaterally, right ischial bone, roof of the right acetabulum and at the junction of the neck and proximal shaft of the left femur and soft tissues as described is not specific for a single etiology. In view of recent history of tuberculous cervical lymphadenitis, the possibility of these lesions representing multifocal tuberculosis should be considered.