59-year-old male. Stage III to IV sacral decubitus ulcer. Evaluate for osteomyelitis. Small deep sacral decubitus ulcer to the left of midline with soft tissue signal abnormality at its base (T1 hypointense and T2 hyperintense) that diffusely enhances consistent with granulation tissue and/or phlegmon. This signal abnormality extends down to the medial left gluteus maximus muscle, which shows focal very mild inflammatory edema type signal. This abnormal soft tissue also abuts a very small area of the coccyx, which demonstrates no signal abnormality to indicate osteomyelitis. No abscess is identified. Chronic deformity of the left ilium, which may be from remote trauma. Mild left SI joint and bilateral hip osteoarthritis. Right femur dynamic screw and sideplate device produces metal artifact, limiting evaluation of adjacent anatomy. Diffusely decreased T1 bone marrow intensity of the lumbar spine and heterogeneous signal intensity of the pelvis, nonspecific, may be seen with red marrow reconversion.Suprapubic catheter terminates in a diffusely thickened bladder with intraluminal air. Rectal catheter is noted. Subcutaneous edema in the left lateral upper thigh.
Small deep sacral decubitus ulcer to the left of midline with soft tissue signal abnormality at the base consistent with granulation tissue and/or phlegmon. No evidence of osteomyelitis in the underlying coccyx.