Bablu

MRI PELVIS / PERINEUM (Plain)

Multiplanar multiecho high resolution sequences of the pelvis / perineum were performed on a 1.5
Tesla Philips Prodiva scanner.

Hx: Pus discharge from perianal region.

FINDINGS:-

Focal lytic destruction involving the inferior pubic ramus and the ischial tuberosity on the right side with a
small intraosseous collection in this region.

Definite cortical breach is seen anteriorly and posteriorly with a blind ending curvilinear fistula extending
anteriorly and superiorly in the intermuscular planes and measures ~ 55 mm in length.

A posterior fistula extending medially, posteriorly and inferiorly for ~ 58 mm is also seen originating from
the intraosseous collection and opens inferiorly in the intergluteal fold posterior to the base of scrotum on
the right side. No obvious extension / relation to the anal canal.

Mild soft tissue inflammation is seen around the ischial tuberosity withy edematous soft tissue seen
around the hamstring tendons.

The hip joint is not involved.

No obvious intersphincteric collection is noted.

Prostate and seminal vesicles are normal.

Urinary bladder is mildly distended and appears normal.

IMPRESSION:-

 Focal lytic destruction involving the inferior pubic ramus and the ischial tuberosity on the right side
with a small intraosseous collection in this region with anterior and posterior fistulae as described
and no obvious relation / involvement of the anal canal or the hip joint – Findings are highly
suggestive of chronic osteomyelitis involving the inferior pubic ramus and ischial
tuberosity with osseous and soft tissue involvement as described.

For clinical correlation and follow up.