62-year-old male with known AVN, neutropenic fever, bacteremia. Rule out osteomyelitis There is marked deformity of the left femoral head with collapse and fragmentation consistent with underlying avascular necrosis as well mottled bone marrow signal intensity consistent with marrow replacement. There are no MRI findings to suggest superimposed osteomyelitis however. The remaining visualized femur is unremarkable. There is mild inflammatory changes within the overlying soft tissues with no fluid collection or abscess or sinus tract extending to the adjacent bones. On the lateral most images there is mottled signal intensity within the vastus lateralis muscle which is incompletely imaged and is nonspecific. Profound metal artifact related to right total hip arthroplasty obscures the right hip. No significant abnormality is noted within the pelvis or remaining soft tissues.
1. Underlying avascular necrosis of the proximal femur with no findings to suggest superimposed osteomyelitis.2. Nonspecific mottled signal intensity within an incompletely visualized vastus lateralis muscle. Consider dedicated imaging if clinically warranted. 