Reason: Assess extent of anterolateral thigh - looking for abscess, tracking areas of edema/possible pus History: Increasing WBC, pain anterolateral hip/thigh Please note that MRI pelvis was not performed due to inability of patient to tolerate exam. Service was paged at the time of the exam without response.There is a large collection of rim-enhancing fluid signal intensity within the subcutaneous fat along the lateral aspect of the right hip that appears to communicate with the skin surface. This collection penetrates the iliotibial band to enter the gluteus medius muscle as well as extending posteromedially between the greater trochanter and gluteus maximus muscle. Anteriorly, the collection extends deep to the tensor fascia lata. The cranial extent of this collection is beyond the field of view of this study. The caudal extent of the collection lies at the level of the subtrochanteric femur and overall the collection is at least 15 cm in craniocaudal dimension and approximately 11 cm in greatest transverse dimension. Foci of signal void within the collection likely represents air. Cutaneous skin staples are noted along the lateral aspect of the hip.Although the gluteus medius muscle is not included in its entirety, additional smaller rim-enhancing collections are noted within the muscle which may communicate with the larger subcutaneous collection. There is edema surrounding the collection with subcutaneous edema along the lateral aspect of the thigh down to just above the knee which appears to enhance, indicating cellulitis. There is also edema of the gluteus maximus muscle, tensor fascia lata, vastus lateralis, vastus intermedius, sartorius and tracking between the quadriceps musculature. Additional edema is present within the adductor muscles of the hip and thigh with relative sparing of the posterior musculature. Diffuse subcutaneous edema is also present. Bone marrow signal intensity is within normal normal limits. Slightly prominent right-sided inguinal lymph nodes are present. Osteoarthritis affects the knee with a small joint effusion.
1.Large rim-enhancing fluid collection with deep extension into the gluteal musculature and extension to the skin surface. We cannot exclude abscess on the basis of this study.2.Other findings as described above.