EURORAD ESR

Case 15725

Osteomyelitis of femur complicating as septic arthritis of hip

Author(s)
Dr. Akshay Pendkar1, Dr. M.T.Makada2 M.D., Dr. N. U. Bahri3 M.D.

1. Third year resident.
2. Associate Professor.
3. Professor and Head.

Department of Radio diagnosis, M.P. Shah Government Medical College, Guru Gobind Singh Government Hospital, Jamnagar, Gujarat, India.

SHRI GURU GOBIND SINGH HOSPITAL, SHRI GURU GOBIND SINGH HOSPITAL; P.N.MARG 361008 Jamnagar, India; Email:drakshay28@gmail.com
 
Patient
male, 14 year(s)
 
 
  • Figure 1
    Plain radiograph of pelvis with both hip

    Destruction of articular surface of head of left femur and acetabulum with cortical irregularity, juxta articular osteopenia, joint space widening, reduction in volume of head of femur with its mild superior and...

     
    Area of Interest: Musculoskeletal joint; Imaging Technique: Conventional radiography; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
  • Figure 2
    Magnetic resonance imaging
     

    STIR coronal image shows diffuse marrow edema within left femoral head, neck, proximal meta-diaphysis. Marrow edema is also noted involving left acetabulum (Arrows) with mild left hip joint effusion.

     
    Area of Interest: Musculoskeletal joint; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Infection;

    T2 coronal image shows linear hypointensity involving proximal meta-diaphysis of left femur suggestive of dead bone / sequestrum. Destruction of femoral head with its resultant mild superolateral dislocation noted.

     
    Area of Interest: Musculoskeletal joint; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Infection;

    T1 coronal image shows linear hypointensity involving proximal meta-diaphysis of left femur suggestive of dead bone / sequestrum. Destruction of femoral head with its resultant mild superolateral dislocation noted.

     
    Area of Interest: Musculoskeletal joint; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
  • Figure 3
    Magnetic resonance imaging
     

    Post contrast coronal image shows thickened synovium showing homogeneous enhancement with mild hip joint effusion.

     
    Area of Interest: Musculoskeletal joint; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Infection;

    Post contrast axial image shows thickened synovium showing homogeneous enhancement with mild hip joint effusion.

     
    Area of Interest: Musculoskeletal joint; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Infection;

    Post contrast sagittal image shows thickened synovium showing homogeneous enhancement with mild hip joint effusion.

     
    Area of Interest: Musculoskeletal joint; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Infection;
     
     
  • Figure 4
    Magnetic resonance imaging

    Post contrast axial image shows peripherally enhancing collection anterior to left hip joint. (Arrow)

     
    Area of Interest: Musculoskeletal joint; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Abscess;
     
     
  • Figure 5
    Magnetic resonance imaging
     

    Post contrast axial image shows soft tissue edema involving gluteus medius and minimus muscle.

     
    Area of Interest: Musculoskeletal soft tissue; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Inflammation;

    Post contrast axial image shows soft tissue edema involving pyriformis and vastus lateralis muscle. Marrow edema is also noted involving left femur.

     
    Area of Interest: Musculoskeletal joint; Imaging Technique: MR; Procedure: Diagnostic procedure; Special Focus: Inflammation;
     
     
Destruction of articular surface of head of left femur and acetabulum with cortical irregularity, juxta articular osteopenia, joint space widening, reduction in volume of head of femur with its mild superior and lateral dislocation.
 
STIR coronal image shows diffuse marrow edema within left femoral head, neck, proximal meta-diaphysis. Marrow edema is also noted involving left acetabulum (Arrows) with mild left hip joint effusion.
 
T2 coronal image shows linear hypointensity involving proximal meta-diaphysis of left femur suggestive of dead bone / sequestrum. Destruction of femoral head with its resultant mild superolateral dislocation noted.
 
T1 coronal image shows linear hypointensity involving proximal meta-diaphysis of left femur suggestive of dead bone / sequestrum. Destruction of femoral head with its resultant mild superolateral dislocation noted.
 
Post contrast coronal image shows thickened synovium showing homogeneous enhancement with mild hip joint effusion.
 
Post contrast axial image shows thickened synovium showing homogeneous enhancement with mild hip joint effusion.
 
Post contrast sagittal image shows thickened synovium showing homogeneous enhancement with mild hip joint effusion.
 
Post contrast axial image shows peripherally enhancing collection anterior to left hip joint. (Arrow)
 
Post contrast axial image shows soft tissue edema involving gluteus medius and minimus muscle.
 
Post contrast axial image shows soft tissue edema involving pyriformis and vastus lateralis muscle. Marrow edema is also noted involving left femur.
 
 
 
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