Left ischium pressure ulcer to bone. Rule out osteomyelitis. Large soft tissue ulceration is seen laterally extending from the skin to the greater trochanter. Surrounding soft tissue edema suggests inflammation or infection. There is cortical loss of the underlying bone and marrow signal abnormality in the proximal femur centered in the greater trochanter, with increased T2 signal and decreased T1 signal as well as enhancement on postcontrast images, compatible with osteomyelitis.Small skin ulceration is also seen in the posterior subcutaneous soft tissues superficial to the coccyx with soft tissue enhancement suggesting inflammation or infection. No clear evidence of marrow signal abnormality, cortical disruption, or abnormal osseous enhancement is seen to suggest underlying osteomyelitis.There are no other areas of bone signal abnormality. Specifically, there is no involvement of the ischium. Small bilateral hip joint effusions are present, right greater than left.
1.Large ulceration of the lateral left hip and underlying osteomyelitis centered in the greater trochanter of the left femur.2.Additional sacral ulcer without evidence of osteomyelitis in this region.