83 year old female with soft tissue infection with abscess formation in perineum and labia. Concern for osteomyelitis. As seen on the patient's recent CT scan, there is reticulation of the mons pubis, particularly to the right of midline, extending posteriorly through the fat of the perineum. Evaluation for abscess is limited due to lack of intravenous contrast enhancement. However, within the mons pubis, there is a small crescentic collection of fluid signal intensity measuring approximately 3.5 cm in the AP dimension, 0.6 cm in the medial lateral dimension, and 1.0 cm in the craniocaudal dimension. There is a focus of signal void within the anterior aspect of this collection suggestive of gas. These findings are suggestive of abscess formation in the absence of recent intervention. Additionally, there are a few smaller, subcentimeter collections seen more anteriorly and superiorly within the mons pubis. The inflammation abuts the medial aspect of the gracilis. There is edema within the gracilis and to a lesser degree within the adductor musculature of the right hip, but we see no definite drainable inter- or intramuscular fluid collection. There is mild edema within the subcutaneous fat posteriorly and laterally which is nonspecific and not necessarily of any current clinical significance. We see no bone marrow signal abnormality to indicate osteomyelitis. There is intermediate signal intensity within the bone marrow on T1-weighted imaging suggesting residual red marrow. There is trace fluid within both hip joints which is within normal limits. The sacroiliac joints appear normal. Mild degenerative disc disease affects the lower lumbar spine. Facet joint osteoarthritis affects the lower lumbar spine.
1. Inflammation of the mons pubis and perineum particularly to the right of midline with small fluid collections, one of which contains a focus of signal void suggestive of gas, compatible with small abscesses. Please note we cannot exclude the possibility of a necrotizing infection.2. We see no evidence of osteomyelitis. Other findings as described above.