Some were curious about the left hip
MRI scout includes the left hip
CAM morphology is bilateral, but there is nothing to suggest Legg Calve Perthes.
There is no left femoral bone lesion.
There is mild cartilage space narrowing on the right side only.
On Mon, Jul 31, 2023 at 3:39 PM hilary umans <hilary.umans> wrote:
My colleague reported the lucent subchondral lesion with sclerotic rim in the context of mild OA…indicating that it was atypical for a simple geode and recommended MRI without and with contrast.
There is obvious femoral CAM morphology, bilaterally, but the lesion is on the Right side only.
I don’t know what is responsible for the Black T1/PDFS "nodular’ central signal (it looks lucent not mineralized on recent XR), nor do I understand what is causing the Bright PDFS signal deep to the sclerotic rim—as there is no enhancement within the lesion itself.
There is perilesional enhancement in the distribution of the perilesional marrow edema-like signal.
In the Obl Ax PDFS image there seems to be a small defect in the subchondral bone, but there is no joint effusion or enhancing synovitis
Again, to illustrate perilesional enhancement only
I’m inclined to call this a chronic osteochondral lesion, though the parafoveal location is odd.
There is superimposed localized cartilage thinning and there is femoral CAM morphology, though I don’t see a labral tear.Is there a differential diagnosis?
Should I recommend CT….why or why not?Thank you.
Hilary
