She would have been 38yo at the time of THR, which is young….I have no history, though XRs from 2017 show Left > Right hip DJD.
I see that she had bariatric surgery in 2012.
She is African American, but there is no reported history of SCD, nor are there bone infarcts in the current exam.
The prosthesis looks normal in SEMAC images
There is the focal lesion in the Greater Trochanter….it’s not much to go on, but in the Axial, there is central dark T1/bright STIR signal, with a thick rind of fat signal and thin rim of sclerosis.
This is more reminiscent of evolving subcortical cyst like changes I see commonly deep to the rotator cuff insertion as opposed to osteolyis.
The Obl PD suggests cortical thinning immediately deep to the degenerative gluteus minimus insertion.
Can I confidently report this as subtendinous cyst like change rather than periprosthetic osteolysis?
Thanks.
Hilary
