47 years, Female, Reason: 47 yr/old female with h/o UC s/p proctocolectomy with IPAA, pouchitis, fissure and now 2 possible fistulae openings on the distal gluteal fold in the tailbone area History: 2 openings with some serosanguiness drainage, small amount in distal gluteal fold area. PELVIS: UTERUS, ADNEXA: No significant abnormality noted.BLADDER: No significant abnormality noted.LYMPH NODES: No significant abnormality noted.BOWEL, MESENTERY: There is a small suprasphinteric sinus tract extending from the left lateral aspect of the rectum (3 o'clock position) approximately 1 cm.BONES, SOFT TISSUES: The tip of the coccyx has high signal intensity on T2 and low signal intensity in T1, suggesting osteomyelitis. There is a sinus tract extending from the coccyx to the left gluteal fluid which may represent a draining sinus.There is heterogeneous increased T2 signal within the prevertebral space which may represent phlegmon.Increased T2 signal adjacent to the right sacroiliac joints is likely degenerative.OTHER: Small Tarlov cysts.
1.Findings compatible with osteomyelitis of the coccyx with a sinus tract draining to the left gluteal fold2.Suprasphincteric sinus tract extending from the left lateral aspect of the rectum.3.Phlegmonous inflammatory changes in the prevertebral space