Vulvar abscess, concern for bony extension There is a large ulceration packing material within the medial soft tissues of the left thigh which extends to but does not appear to invade the rectum. There is marked edema and enhancement throughout the pelvic musculature bilaterally, left greater than right but there is no discrete fluid collection identified.There is a small focus of edema and enhancement within the left inferior pubic ramus but there is no corresponding low signal intensity on T1 to confirm osteomyelitis in these findings likely reflect reactive osteitis. There is marked abnormal signal intensity and enhancement of the left hip involving both the acetabulum and femoral head/neck. There is a trace amount of joint fluid but no joint effusion. Abnormal signal intensity and enhancement is also present within the posterior column of the right acetabulum which is presumably degenerative in nature. A Foley catheter in place.
1. Large ulceration of the medial soft tissues of the left pelvis without definite evidence of osteomyelitis or discrete fluid collection. There is abnormal signal intensity the left inferior pubic ramus which is likely reflects reactive osteitis given the lack of corresponding low T1 signal intensity.2. Severe osteoarthritis of the left hip with associated degenerative marrow signal changes.3. Diffuse edema and enhancement of the adductor musculature bilaterally which may represent myositis but is also likely in part related to prior radiation therapy.