64-year-old female with right hip pain, evaluate for osteonecrosis The bone marrow signal intensity is within normal limits, and we see no fracture or osteonecrosis. There is no hip joint effusion. Mild osteoarthritic changes affect the hip, which are better seen on recent CT. The pubic symphysis and sacroiliac joints are within normal limits.There is a mass along the medial surface of the right iliac wing that appears to be centered in the iliacus muscle and displaces the psoas muscle medially. There are no signs of bony invasion. The mass is approximately 56 x 33 mm in the transverse dimension, and approximately 88 mm in the oblique craniocaudal dimension. On T2-weighted images, it is of heterogeneous signal intensity with regions that are hypointense, isointense, and hyperintense relative to the skeletal muscles. The mass is also of heterogeneous signal on T1-weighted images, and is predominantly isointense with some regions of hyperintensity relative to the skeletal muscles. Mild edema-type signal extends distally from the mass along the course of the iliopsoas muscles and tendon to the lesser trochanter.
1. No evidence of osteonecrosis.2. Soft tissue mass along the medial aspect of the right iliac wing centered in the iliacus muscle as described above. Please note that this mass is not included in its entirety on many of the sequences of this hip MRI study. Its signal characteristics suggest the possibility of hematoma. However, it is impossible to exclude a malignancy on this study. We would recommend MRI of the pelvis with and without contrast for further evaluation.