Reason: evaluate for labral tear vs hernia History: progressive pain with ambulation and coughing Moderate to severe osteoarthritis affects the hip with full-thickness degeneration of the articular cartilage along the anterior superior aspect of the joint. There is associated osteophyte formation. There is mild enhancement of the hip joint following contrast administration indicating a mild synovitis. Subchondral foci of signal abnormality also show enhancement following contrast administration and could either represent enhancing degenerative "geodes" or erosions, however, we see no joint effusion. There is deformity and increased signal intensity within the acetabular labrum, particularly superiorly, likely representing a combination of mucoid degeneration and degenerative tearing. There is relatively mild osteoarthritis of the left hip. There is a small cyst adjacent to the left superior labrum that may reflect an underlying labral tear. Mild osteoarthritis affects the pubic symphysis. Mild osteoarthritis affects the sacroiliac joints. Severe degenerative disc disease affects the imaged lower lumbar spine.The skin appears unusually thickened and there is little subcutaneous fat between the skin and underlying gluteus maximus muscle and virtually no fat within many of the imaged muscles. The subcutaneous fat that is present posteriorly shows reticulation and enhancement suggesting mild inflammation extending along the lateral aspect of the hip. Review of the patient's medical records indicates a history of lower extremity sclerosing skin process with atypical fasciitis/lipodystrophy syndrome. There is a large uterine mass presumably representing a fibroid that was present on a prior CT examination from 2008. We see no hernia.
1. Moderate to severe osteoarthritis of the right hip with mild synovitis and enhancing subchondral foci that could represent degenerative geodes or small erosions. We see no joint effusion.2. Degeneration and tearing of the acetabular labrum.3. Other findings as described above including osteoarthritis, degenerative disc disease, a uterine fibroid, and findings compatible with the patient's history of a lower extremity sclerosing skin process with atypical fasciitis/lipodystrophy syndrome.