Case Challenge

Hip & Thigh

Stephen J Pomeranz

Gain confidence interpreting Hip MRI with practice cases from MRI Online. Quiz yourself using real-world DICOMs & earn CME. Try it free!

Case Review

Musculoskeletal (MSK)

Post-Course Activities

This Power Pack is comprised of 25 unique Hip MRI cases that you can scroll through in our diagnostic web viewer to determine your findings. Quiz yourself and earn CME.

Hip MRI Cases

Case 7 - 71-year-old male presents with moderate worsening pain in left hip

<div>HISTORY:&#160;This 71-year-old male presents with moderate worsening pain in left hip, worse at night. History of prostate cancer, treated with seed implant.PRIMARY FINDING:&#160;Malignant appearing osseous and soft tissue mass.Using the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS: A complex lytic and expansile mass arising from the greater trochanter and lateral aspect of the proximal left femoral diaphysis is observed. It extends distal to the imaging field of view measuring at least 12.0cm in length, 6.0cm in AP dimension and 6.0cm in transverse dimension. It results in anterolateral displacement of the tensor fascia lata muscle. Adjacent muscle group edema is identified. Edema involving the medial aspect of the obturator externus muscle is present.&#160;There is no evidence of acute osseous injury. No femoral head osteonecrosis is observed. A small hip joint effusion is present.&#160;IMPRESSION: Left Hip: Complex aggressive or malignant appearing osseous and soft tissue mass involving the left greater trochanter and lateral aspect of the proximal femoral diaphysis measuring at least 12.0cm in length, 6.0cm in transverse dimension and 6.0cm in AP dimension. Differential diagnostic considerations include both primary and metastatic neoplasm. Additional axial, sagittal and coronal T1 weighted and T2 fat-saturated imaging of the hip and thigh is recommended to determine its extent and compartmental involvement.&#160;Strain or inflammation involving the medial aspect of the obturator externus muscle and the gluteus minimus muscle.&#160;No evidence of osteonecrosis.</div>

Case

Malignant appearing osseous and soft tissue mass

What is the primary finding in this case?