Reason: eval for sacroiliac infection History: as above Again seen is increased bone marrow signal abnormality about the left sacroiliac joint with associated erosion and deformity with minimal, if any, enhancement on postcontrast sequences. These findings may represent changes related to chronic osteomyelitis. However, the degree of enhancement and bone marrow signal abnormality on fluid sensitive sequences within the left iliac bone and left sacral wing appears decreased when compared to the prior examination. No additional bone marrow signal abnormality is identified. There is an apparent small focus of ossification within this erosion which could again conceivably represent a sequestration, although this was better seen on prior CT examinations. If the case, this site could conceivably serve as a nidus for continued infection which may be poorly demonstrated by imaging.Severe degenerative disc disease affects the imaged lower lumbar spine. Moderate osteoarthritis affects the hips. The imaged musculature of the pelvis is unremarkable. No focal fluid collection is identified to suggest abscess formation.
Bone marrow signal abnormality and erosive changes about the left sacroiliac joint. While there is interval decrease in bone marrow signal abnormality in the surrounding area and enhancement, this remains suspicious for chronic infectious/inflammatory changes in the correct clinical context. Other findings as described above.