34-year-old female with muscle weakness and EMG consistent with inflammatory myositis, evaluate for inflammation/necrosis and possible biopsy site Right femur: On the fat-suppressed T2-weighted images, there is increased signal intensity of the muscle belly of the rectus femoris, anterior fibers of the mid vastus lateralis as well as the sartorius to a lesser degree. There is also mild signal intensity of the hamstring muscles as well as the adductor magnus and gracilis. There is also mild signal intensity of the adductor longus and brevis muscles. The vastus medialis and vastus intermedius appear normal. Following contrast administration, there is enhancement of the rectus femoris muscle and anterior fibers of the vastus lateralis muscle. There is perhaps mild fatty atrophy of the hamstring and adductor muscles in addition to the sartorius although this is equivocal. We see no additional soft tissue abnormalities. No abnormal bone marrow signal.Left femur: On the fat-suppressed T2-weighted images, there is increased signal intensity of the muscle belly of the rectus femoris, anterior fibers of the vastus lateralis, vastus medialis and sartorius. There is mild increased signal intensity of the hamstring muscles, adductor magnus and gracilis. There is relative sparing of the vastus intermedius. Following contrast administration, there is mild enhancement of the rectus femoris. There is perhaps mild fatty atrophy of the hamstring muscles and adductor magnus muscle in addition to the gracilis and sartorius. We see no additional soft tissue abnormalities. No abnormal bone marrow signal.Other: Small foci of low signal within the uterus may represent fibroids. Incompletely imaged is an approximately 5 cm collection of fluid signal intensity with thin enhancing margin along the anterior and superior aspect of the uterus. This could represent an adnexal cyst. Follow-up is recommended with ultrasound.
1.Findings compatible with myositis as described above with enhancement most prominently involving the rectus femoris muscles bilaterally.2.Incompletely imaged cystic appearing collection in the pelvis for which follow-up with ultrasound is recommended.Findings discussed with Dr. Bhatia at 1021 on 5/13/15. 