Male, 40 years old, with osteomyelitis, evaluate for the amount and location of soft tissue involvement tracking into the hardware to assist with surgical decision making. Despite adjustment of MR imaging parameters to suppress metallic artifact, artifact related to the patient's extensive orthopedic instrumentation significantly obscures visualization of the lumbar spine. Within this limitation, the following observations are made.A leftward rotoscoliosis of the lumbar spine is seen. Osseous marrow signal is not reliably assessed due to imaging artifact. However, the posterior paraspinal muscles are edematous and enhancing, particularly on the right, from L1 down. Scarlike tissue is evident within the paraspinal and subcutaneous tissues posterior to the left iliac bone. No definite fluid collections are seen. No definite anterior paraspinal edema is detected.
Very limited examination due to artifact from orthopedic instrumentation. The vertebral bodies and spinal canal are not adequately visualized for accurate assessment.Note is made, however, of extensive posterior paraspinal edema and inflammation, particularly on the right which begins at the L1 level and continues inferiorly to at least L5 if not to the sacral level. No large or definite fluid collections are seen.