Left hip infection Note that evaluation of the bones and soft tissues is limited secondary to metallic susceptibility artifact from the left hip arthroplasty.The previously described fluid collection along the posterior and inferior ischium is no longer seen. In its place is a large soft tissue defect involving the subcutaneous fat of the medial left buttock which contains packing material. A rind of abnormal signal surrounding the defect is seen which likely reflects a combination of granulation tissue and edema. This abnormal signal extends to the left ischium but there is no abnormal signal within the ischium itself to confirm the presence of osteomyelitis.Inflammatory changes surround the sciatic nerve and proximal hamstring tendons however we see no frank edema of the musculature of the upper thigh. There is atrophy of the proximal hamstring musculature. There is atrophy of the iliopsoas and gluteal musculature. There is scarring traversing the posterolateral subcutaneous fat which is likely the result of the prior total hip arthroplasty. A small fluid collection is seen immediately posterior to the greater tuberosity which is essentially unchanged in appearance and may represent a seroma. Although evaluation of the left hip is limited due to the susceptibility artifact, there are no specific imaging features of septic arthritis identified.There is mild osteoarthritis of the right hip and mild degenerative disc disease of the lower lumbar spine. A small amount of fluid is noted within the sacroiliac joints which is of uncertain clinical significance. A renal transplant is noted in the left iliac fossa and the urinary bladder is distended.
Limited examination secondary to metallic susceptibility artifact. A large left posterior buttock wound is noted with extension to the ischium however there is no abnormal signal within the ischium to confirm osteomyelitis. Additional findings are described above.