Osteomyelitis, pelvis, MR
Claim CME CreditPOINT OF CARE INFORMATION
This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.
Learning Objectives
As a result of participation in this activity, participants should be able to:
- Provide improved patient care.
- Greater knowledge of the imaging characteristics of the patient's disease.
- Understand a better approach to interpretation of studies.
Faculty Disclosure
Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.
CME Advisory Committee Disclosure:
Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.
Continuing Medical Education Credit
Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CB1143-Osteomyelitis, pelvis, MR
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CB1143-Osteomyelitis, pelvis, MR
Case ReportHistory
Exam
Findings
Findings
Pressure ulcer overlying the right ischial tuberosity. Large soft tissue defect with peripherally enhancing margins extending from the skin surface down to the underlying ischial tuberosity. There is mild edema of the right adductor muscles, either infectious or reactive myositis.
There is increased T2 signal and enhancement within the right ischial tuberosity and inferior pubic ramus. There is confluent loss of T1 signal in this region. There is osseous destruction of the cortex of the ischial tuberosity, directly deep to the soft tissue defect. These findings are consistent with acute osteomyelitis. Marrow enhancement is present in this region, consistent with maintenance of bone viability.
Pressure related change adjacent to the left ischial tuberosity. The signal abnormalities in the subcutaneous tissues extend from the skin surface down to the bone of the ischial tuberosity. There is no surrounding edema to suggest infection. There are no drainable fluid collections at this location. No evidence for acute osteomyelitis at this location.
Pressure related changes overlying the sacrum as well. There is deformity of the sacrum, either reflecting chronic osteomyelitis or pressure related changes. Negative for acute inflammation at this location.
Chronic osseous deformity of the right hip with dislocation and surrounding heterotopic ossification. Chronic osseous deformity of the left hip with chronic dislocation also noted.
Focus of heterotopic ossification adjacent to the sacrum.
Spinal dysraphism. Diffuse muscular atrophy.
Suprapubic catheter.
Impression
Pressure injuries overlying the sacrum and left ischial tuberosity without evidence for superimposed acute infection.
Multiple other ancillary findings as above.
