Reason: 53 yo F paraplegic, h/o L hip osteomyelitis now with recurrent drainage from L hip sinus; rule out tract; rule out active osteo History: see above. Again seen is skin ulceration and sinus tract overlying the left greater trochanter with surrounding soft tissue edema. Previously seen fluid and gas collection overlying the greater trochanter has decreased in size compared to prior, measuring approximately 2.7 x 1.6 cm, previously 4.9 x 2.4 cm. The previously seen discrete overlying gas collection is no longer visualized. No definite evidence of acute osteomyelitis.Previously seen fluid collection overlying the right greater trochanter measures 2.8 x 1.4 cm, previously 2.5 x 1.6 cm.Diffuse muscle atrophy. Edema within the left gluteal musculature has slightly decreased compared to prior. Edema within the left upper thigh musculature has resolved.Foley catheter in place. Gas within the bladder likely related to recent instrumentation. Small bilateral pelvic lymph nodes again noted, likely reactive.
1.Interval decrease in fluid collection likely representing abscess overlying the left greater trochanter with surrounding inflammatory changes and overlying skin ulceration. No definite evidence of underlying osteomyelitis. 2.Fluid collection overlying the right greater trochanter is not significantly changed. Enhancement cannot be assessed on the current examination without intravenous contrast. This collection was previously described as suggestive of trochanteric bursitis due to lack of rim enhancement.