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Focal Pyomyositis of the Perisciatic Muscles in Children

Ramiro J. Hernandez1, Peter J. Strouse1, Clifford L. Craig2 and Frances A. Farley2

1 Department of Radiology, University of Michigan Health System, C.S. Mott Children's Hospital, 1500 E. Medical Center Dr., Ann Arbor, MI 48109-0252.
2 Department of Orthopedics, University of Michigan Health System, C.S. Mott Children's Hospital, Ann Arbor, MI 48109-0252.



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Fig. 1A. 17-year-old boy with 3-day history of pain and inability to walk. Axial fat-suppressed fast spin-echo proton density MR image (TR/TE, 4166/15) shows increase in signal intensity of right piriformis muscle (arrow).

 


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Fig. 1B. 17-year-old boy with 3-day history of pain and inability to walk. Axial fat-suppressed T1-weighted MR image (550/14) obtained after gadolinium administration shows marked enhancement of right piriformis muscle (arrow) and adjacent structures, such as gluteus medius muscle (arrowhead).

 


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Fig. 2A. 13-year-old boy with 2-day history of pain and inability to walk. Fast spin-echo T2-weighted axial MR image (TR/TE, 4000/90) obtained through pelvis shows soft-tissue mass with increased high signal intensity involving right piriformis muscle (arrow).

 


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Fig. 2B. 13-year-old boy with 2-day history of pain and inability to walk. Fast spin-echo inversion recovery coronal MR image (5500/24; inversion time, 165 msec) shows high signal intensity involving structures in right sciatic notch (arrow).

 


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Fig. 2C. 13-year-old boy with 2-day history of pain and inability to walk. Axial fat-suppressed T1-weighted MR image (650/14) obtained after gadolinium administration shows enhancement of soft-tissue mass involving right piriformis muscle (arrow). Within mass, low-signal-intensity areas (arrowhead), probably representing small abscesses, are visible.

 


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Fig. 3A. 6-year-old girl with 1-day history of left hip pain. Axial fat-suppressed fast spin-echo T2-weighted MR image (TR/TE, 4000/60) shows increase in signal intensity of left superior gemellus (arrow) and obturator internus (arrowhead) muscles.

 


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Fig. 3B. 6-year-old girl with 1-day history of left hip pain. Axial fat-suppressed T1-weighted MR image (750/14) obtained after gadolinium administration shows marked enhancement of left superior gemellus (arrow) and obturator internus (arrowhead) muscles.

 


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Fig. 3C. 6-year-old girl with 1-day history of left hip pain. Axial fast spin-echo T2-weighted MR image (4000/60) shows increase in signal intensity of left obturator internus muscle (arrowheads) and perisciatic soft tissues. Arrow denotes expected location of sciatic nerve.

 


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Fig. 3D. 6-year-old girl with 1-day history of left hip pain. Axial fat-suppressed T1-weighted MR image (750/14) obtained after gadolinium administration shows marked enhancement of left obturator internus muscle (arrowheads) and perisciatic soft tissues. Arrow denotes expected location of sciatic nerve.

 

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