Evaluate bony lesion in left proximal femur History: Night leg pain, left quadriceps atrophy, weight loss, and increased ESR. Centered within the anterior cortex of the left proximal femoral diaphysis, there is an approximately 8 mm cortically based targetoid lesion with associated surrounding cortical thickening (series 1401, image 16). The cortical thickening extends for a length of approximately 7 cm. The targetoid lesion demonstrates increased T2 signal peripherally with low T1 and T2 signal centrally. The periphery of the targeted lesion demonstrates increased enhancement. At the level of the targetoid lesion, there is an approximately 7 cm segment of bone marrow edema and increased bone marrow enhancement (series 1301, image 12). The remaining portions of the left femur demonstrate normal signal intensity. On the large field-of-view images, the right femur also appears normal.The musculature of left thigh is atrophic compared to the right.
Cortically based left proximal femoral lesion most suggestive of an osteoid osteoma. Correlation with plain radiography is recommended.