Sacral decubitus ulcer There is decubitus ulceration overlying the sacrum with a small area of low T1/high T2 signal involving the distal coccyx consistent with a small focus of osteomyelitis. This is best appreciated on sagittal image 33/65 of series 9 and image 29/34 of series 3. There is soft tissue edema overlying the sacrum/coccyx but no discrete fluid collection identified. Scattered areas of heterogeneous marrow signal within the remaining sacrum may be reactive in nature.There is irregularity of the tendon of the left gluteus maximus with a large amount of increased signal surrounding the muscle suggestive of partial tear of the tendon and muscle. There is diffuse muscle atrophy. Deformity of the right hip/pelvis relates to Paget's as seen on prior CT.
1. Small focus of osteomyelitis involving the distal coccyx. This finding represents a discrepancy with initial preliminary report and was conveyed to Dr. P. Mehta of the admitting service at the time of dictation.2. Partial tear of the left gluteus maximus tendon/muscle.