Status post right hip scar revision now with possible wound infection. History of osteomyelitis of hip. Pain, erythema, swelling.IMAGE ACQUISITIONS: Computed tomography of the pelvis performed following intravenous administration of 120 cc of Omnipaque 350, with transverse, coronal, and sagittal reformatted images of the pelvis and right hip. Absence of the right femoral head and neck with tubular sclerosis in the proximal femoral diaphysis likely represents the sequela of removal of a total hip arthroplasty device. Within the subcutaneous fat just lateral to the proximal aspect of the right femur and iliotibial band is a fluid collection that is approximately 7.5 x 5.5 cm in transverse dimension and nearly 20 cm in craniocaudal dimension. Multiple foci of air density are noted within this collection, which may be due to recent intervention, although we cannot exclude an abcess with a gas forming organism. On coronal image 61 of series 80240, the fluid appears to communicate via a thin track with a smaller collection of fluid in the hip joint. While no gross bone destruction is evident at this time, portions of the posterior cortex of the proximal femur are indistinct; the relatively fatty appearance of the underlying marrow, however, argues against active osteomyelitis. Please note that MRI would be more sensitive for detection of osteomyelitis than CT.Mild osteoarthritis affects the left hip. Mild to moderate degenerative disk disease affects the visualized lower lumbar spine. Moderate facet joint osteoarthritis affects the visualized lower lumbar spine.There is diffuse fatty atrophy of the musculature of the right hip and proximal thigh. A few mildly enlarged inguinal lymph nodes are noted on the right.The visualized intrapelvic structures are unremarkable given limitation of lack of enteric contrast material.
Fluid collection in the lateral aspect of the proximal thigh and as described above which may represent an abscess.