Reason: evaluate for osteomyelitis History: R buttock tunneled ulceration Suboptimal evaluation secondary to patient motion artifact.There is made of diffuse bone marrow signal abnormality which is nonspecific and can be seen in anemia or myeloproliferative disorders. There is a large soft tissue ulceration along the posterior aspect of the left hemipelvis which extends to the level of the posterior margin of the coccyx. There is increased signal abnormality and T2-weighted sequences and decreased signal abnormality on T1-weighted images indicating osteomyelitis of the first and second coccygeal segments. There is also increased signal abnormality within the third and fourth coccygeal segments on fluid sensitive sequences without corresponding decreased T1 signal abnormality. This likely represents reactive osteitis. There is diffuse subcutaneous and soft tissue edema about the pelvis which is nonspecific.A rectal tube is in place. Mild degenerative disc disease affects the imaged lower lumbar spine. A large amount of abdominopelvic ascites is incompletely imaged. Although this examination was not protocoled for detailed evaluation of the pelvic viscera, there are multiple presumed uterine fibroids which are incompletely characterized. There is marked fatty atrophy of the imaged musculature of the pelvis as well as the imaged paraspinal musculature. Metallic susceptibility artifact from the patient's orthopedic fixation of the left femur limits evaluation of the left hip.
Large soft tissue ulceration extending to the level of the coccyx with findings indicating osteomyelitis of the first and second coccygeal segments and reactive osteitis of the third and fourth coccygeal segments. Other findings as described above. These findings were relayed to Dr. Podolej by phone at 9:53 AM on 1/29/2016.