History of sacral decubitus ulcer and fever, evaluate for osteomyelitis. BONE MARROW: Scattered foci of decreased T1 marrow signal are present in a distribution suggestive of red marrow reconversion. Abnormally decreased T1 signal and increased T2 signal with associated contrast enhancement is present within the lesser trochanter of the right femur (series 401, image 21) compatible with osteomyelitis. There is abnormally decreased T1 signal with associated abnormally increased T2 signal with associated increased heterogenous enhancement involving the right ischial tuberosity (series 401, image 24) which is also suspicious for osteomyelitis. There is abnormally decreased T1 signal with associated increased T2 signal and enhancement involving the left ischial tuberosity (series 401, image 24) which is compatible with osteomyelitis. Abnormal signal extends from the bilateral ischial tuberosities into the adjacent inferior pubic rami. The bone marrow of the sacrum appears within normal limits.SOFT TISSUES: Extensive soft tissue ulceration is present superficial to the bilateral ischial tuberosities and right lesser trochanter with foci of air extending to the aforementioned bones. There is associated increased soft tissue enhancement compatible with infection. No discrete drainable fluid collections are identified.JOINTS: Small joint effusions present bilaterally.ADDITIONAL
1.Decubitus ulcers with associated osteomyelitis of the right lesser trochanter of the femur as well as bilateral ischial tuberosities.2.Small bilateral hip joint effusions. Given presence of adjacent osteomyelitis, infection of the joint spaces cannot be excluded.