80-year-old man with past medical history of colon cancer presents with severe lower back and right lateral hip pain. Severe osteoarthritis of the right hip has progressed when compared to CT dated 10/18/2013. This hip joint now appears essentially devoid of articular cartilage and there is flattening of the superior aspect of the femoral head. Multiple subchondral cysts and/or chronic erosions within the femoral head and acetabulum are seen. There is a small amount of fluid within the hip joint and extending anteriorly into a synovial recess that in retrospect was present on prior CT scan. There is also enhancement of the hip joint indicating synovitis. Edema type signal and enhancement of the femoral head extending into the intertrochanteric region as well as the acetabulum is suspected to be arthritic in etiology. Overall, these findings indicate progression of osteoarthritis perhaps secondary to underlying inflammatory or depositional arthritis. The distribution of signal intensity abnormality in the bone marrow is more in keeping with an arthritic process than a neoplastic one.There is a small amount of peritrochanteric fluid enhancement on the right relative to the left which may reflect a mild bursitis.There is also mild edema and enhancement of the adjacent gluteal and flexor musculature of the hip that is nonspecific but may reflect altered biomechanics or myositis. There is mild atrophy of gluteal and hip musculature, right greater than left.Relatively mild osteoarthritis affects the left hip.The sacroiliac joints appear normal.Mild degenerative disc disease and facet joint osteoarthritis affect the lower lumbar spine.The remaining bone marrow signal intensity is within normal limits.
1. Severe osteoarthritis of the right hip that has progressed when compared to the prior study and may be secondary to underlying chronic inflammatory or depositional arthritis. Bone marrow signal abnormalities are felt to be arthritic in etiology as well. We see no focal lesions to indicate metastatic disease to bone.2. Inflammatory changes of the musculature of the right hip and along the right greater trochanter as above.