Sacral decubitus ulcer, evaluate for osteomyelitis There is a large ulceration of the left gluteal soft tissues which abuts and involves a portion of the left posterior ischium. The posterior ischium demonstrates abnormal signal intensity on both T1 and T2-weighted sequences consistent with osteomyelitis. Abnormal marrow signal intensity also involves a portion of the posterior medial acetabulum but the femoral head is of normal marrow signal intensity. Following contrast administration, there is abnormal enhancement of the posterior ischium and acetabulum reflecting inflammation. There is surrounding soft tissue edema and enhancement reflecting additional inflammation. There is diffuse muscle atrophy and deformity of the pelvis related to the patient's underlying spina bifida.A small left-sided hip joint effusion is present.
Ulceration of the left gluteal soft tissues with osteomyelitis of the left ischium and a portion of the posteromedial acetabulum. The marrow signal of the femoral head is normal.