Reason: history of renal transplant concern for infection, previous MRI with findings concerning for left clavicle osteomyelitis, please include this in views to evaluate for osteomyelitis. LUNGS AND PLEURA: Moderate to large bilateral pleural effusions, not significantly changed compared 8/15/2016 PET with a small amount of associated compressive atelectasis. MEDIASTINUM AND HILA: Normal heart size without pericardial effusion. No mediastinal lymphadenopathy identified.CHEST WALL AND SOFT TISSUES: There is redemonstration of edema/fluid signal as well as increased enhancement within the fascial planes of the left upper chest wall surrounding the proximal and middle third of the left clavicle which is compatible with an inflammatory process such as cellulitis. There is also abnormal bone marrow signal, cortical indistinctness, and increased enhancement involving the proximal and to a lesser extent middle third of the left clavicle which is compatible with osteomyelitis which has progressed compared to the 8/15/2016 MRI neck. No associated discrete drainable abscess is identified.Degenerative changes affect the spine. There is a fat-containing structure within the T3 vertebral body which likely represents a benign hemangioma. There is redemonstration of a nonspecific T2 hyperintense nodule in the subcutaneous soft tissues of the left upper back.UPPER ABDOMEN: Cholelithiasis.
1.Signal abnormality and increased enhancement involving the proximal and middle third of the left clavicle compatible with osteomyelitis, progressed compared to 8/15/2016. Surrounding inflammatory changes compatible with cellulitis.2.Moderate to large bilateral pleural effusions.3.Please see recent dedicated MRIs of the soft tissues of the neck and left shoulder for additional details regarding those structures.