Reason: evaluation soft tissue and muscle inflammation around R hip and upper thigh. History: pain, swelling, inflammation There are foci of signal void within the soft tissues of the right hip likely reflecting metallic susceptibility artifact from prior surgery. There is mild deformity of the anterior femoral head/neck junction likely reflecting prior osteoplasty. There is a small amount of edema and enhancement within the lateral aspect of the femoral head which is nonspecific but not clearly evident on the prior study. There is a small amount of fluid within the right hip joint, but we see no frank synovitis. Please note that this study was not protocoled for detailed evaluation of the acetabular labrum. There is enhancement of the soft tissues along the lateral margin of the greater trochanter as well as within the soft tissues anterior and superior to the femoral neck as well as a small amount of enhancement within the direct head of the rectus femoris, at its origin There are also linear foci of enhancement within the tensor fascia lata muscle that we presume reflect postoperative scarring. There is moderate atrophy of the right gluteus minimus muscle. Portions of the gluteus minimus tendon are indistinct at the insertion on the anterior facet of the greater trochanter indicating at least partial thickness tearing. The remaining musculature of the right hip is unremarkable. The remaining musculature of the pelvis is unremarkable. There is avascular necrosis of the left femoral head without evidence of subchondral fracture or collapse. There is minimal peritrochanteric enhancement on the left, which is not necessarily of any clinical significance. There is a small amount of fluid within the left hip joint with no evidence of a synovitis. The sacroiliac joints are within normal limits. Mild degenerative disc disease affects the imaged lower lumbar spine.
Surgical changes involving the right hip, as described above, with enhancement of the adjacent soft tissues likely reflecting a combination of scarring and mild inflammation. There is also atrophy of the right gluteus minimus muscle and at least partial-thickness tearing of the gluteus minimus tendon at its insertion on the anterior facet of the greater trochanter. Other findings as described above.