Reason: assess for infection or etiology of pain and weakness History: pain with passive rotation of BLE, suggesting an additional hip pathology. Again seen are findings compatible with the patient's known history of L4/L5 discitis and osteomyelitis with epidural extension as seen on the prior lumbar spine MRI examination dated 3/5/2016. Again seen is involvement of the paraspinal musculature, appearing similar to the prior study. Please refer to the dedicated lumbar spine examination report for additional details. We see no bone marrow signal abnormality within the sacrum, bones of the pelvis, or proximal femora. Mild osteoarthritis affects both hips. There is a small amount of fluid within the hips, but no evidence of a large effusion. There is minimal synovial enhancement on postcontrast sequences which is of doubtful clinical significance. There is edema and enhancement extending along the iliacus and psoas musculature within the pelvis, but we see no fluid collection to suggest abscess formation. There is mild edema within the soft tissues anterior to the greater trochanter, right greater than left, which is nonspecific, and we see no enhancement. There is a right iliac fossa transplant kidney. There are slightly prominent iliac and inguinal nodes which may be reactive in etiology.
1. Findings of discitis/osteomyelitis affecting the level of L4/L5 as described on the recent MRI lumbar spine examination report. There is inflammation which extends into the pelvis along the psoas muscle, bilaterally, but we see no drainable fluid collection.2. Mild osteoarthritis of both hips.3. Other findings as described above.