Reason: 70 with TBI, here with fevers, AMS. Has unstageable sacral wound w/eschar. Requesting MRI of sacrum to evaluate for abscess or osteo History: fevers with large sacral wound Intravenous contrast was not able to be administered due to a malfunctioning IV.There is diffuse nonspecific subcutaneous edema most pronounced along the anterior and lateral aspects of the pelvis. There is also increased signal abnormality within the gluteal musculature, right greater than left. There is increased signal abnormality within the iliacus and paraspinal muscles bilaterally which is nonspecific. There is also increased signal abnormality within the imaged musculature of the left hip with some of this inflammatory change/edema becoming confluent within the vastus lateralis musculature. Superimposed infection cannot be excluded. There is minimal soft tissue irregularity along the posterior aspect of the sacrum consistent with the stated history of ulceration. There is extension of this ulceration to the level of the left gluteal musculature. There is associated subcutaneous inflammatory change as well as inflammatory change within the left gluteus maximus musculature. There is a loculated focus of fluid signal intensity within the medial aspect of the left gluteus maximus muscle, measuring approximately 2.0 x 2.0 cm in transverse dimensions, as well as a fluid collection within the presacral space which may represent early abscess formation versus confluent inflammatory change/phlegmon.A Foley catheter is in place. Note is made of a 2.1 cm focus of fluid signal intensity along the right posterolateral aspect of the urethra which may represent a urethral diverticulum. There is a small amount of fluid identified within both hips which is not necessarily of any current clinical significance.
Soft tissue ulceration along the posterior aspect of the sacrum with inflammatory change in the subcutaneous and surrounding soft tissues including a 2.0 cm loculated fluid collection in the left gluteus maximus muscle as well as a presacral fluid collection which may represent early abscess formation versus confluent inflammatory change/phlegmon, although these findings are incompletely characterized on this noncontrast examination. Diffuse nonspecific subcutaneous and soft tissue edema/inflammatory change about the pelvis. No evidence of osteomyelitis. Other findings as described.