Decubitus ulcer. Evaluate osteo-. There is gas within the soft tissues extending along the greater trochanter and subtrochanteric femur. The margins of the adjacent greater trochanter are indistinct compatible with osteomyelitis as seen on the recent MRI examination. Heterotopic mineralization superior to the greater trochanter has perhaps increased slightly when compared with the prior study. Additional gas density is noted in the soft tissues more posteriorly, appearing to extend to the inferior pubic ramus/ischium. The inferior pubic ramus/ischium are sclerotic with adjacent bone formation, compatible with chronic osteomyelitis. Overall, the bones appear demineralized. Mild osteoarthritis affects both hips. The lower sacrum and coccyx are not well visualized due to demineralization and overlying bowel contents. Facet joint osteoarthritis and degenerative disc disease affect the lower lumbar spine. Overall the findings are similar to those seen on the pelvis radiograph from November 28 accounting for positional and technical differences.
Soft tissue ulceration/gas with radiographic features of osteomyelitis of the left greater trochanter and inferior pubic ramus/ischium appearing similar to the prior study.