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5-year-old female with hip pain

Case Study
Braff, Steven, M.D. Burlington, Fletcher Allen Health Care USA
Filippi, Christopher, M.D. Burlington, Fletcher Allen Health Care USA

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Patient history:

A 5-year-old girl presented at Fletcher Allen Health Care with chronic right hip pain.

Initial x-rays showed faint sclerosis of the iliac crest.

MR images and interpretation:

T1-weighted TSE TR 800 ms, TE 20 ms, 1.0 NSA using SENSE Cardiac coilcoronal STIR-TSE TR 4656 ms, TE 20 ms, 1.0 NSA
T1-weighted TSE
coronal STIR-TSE
TR 800 ms, TE 20 ms, 1.0 NSA using SENSE Cardiac coil
TR 4656 ms, TE 20 ms, 1.0 NSA
coronal STIR-TSE TR 4656 ms, TE 20 ms, 1.0 NSAaxial STIR-TSE TR 4966 ms, TE 20 ms, 1.0 NSA
coronal STIR-TSE
axial STIR-TSE
TR 4656 ms, TE 20 ms, 1.0 NSA
TR 4966 ms, TE 20 ms, 1.0 NSA

 

The T1-weighted image shows complete marrow replacement of iliac crest with large soft tissue mass.

 

In the coronal STIR-TSE image, diffuse abnormal marrow signal and large soft tissue mass and areas of spiculated hypointensity perpendicular to cortex, which suggests sunbursttype periosteal new bone formation.  The third image shows marked periosteal new bone formation.

 

The axial STIR-TSE image demonstrates the large soft tissue mass and invasion into the gluteal musculature.

Diagnosis

Diagnosis after biopsy of mass was osteosarcoma.

 

 

 

For background information, see:



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Aug 15, 2006

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Case Study
Achieva 3.0T
Release 1
Quasar Dual
Hip, Musculoskeletal, Pediatric
 

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