Sacrococcygeal osteomyelitis and abscess

Case contributed by Bahman Rasuli
Diagnosis almost certain

Presentation

Sacral pressure ulcer.

Patient Data

Age: 55 years
Gender: Female
This study is a stack
Axial
T2
This study is a stack
Sagittal
T2
This study is a stack
Sagittal
T1
This study is a stack
Coronal
T1
This study is a stack
Coronal
T2
This study is a stack
Sagittal
T2 fat sat
This study is a stack
Axial T2
fat sat
This study is a stack
Axial T1
C+ fat sat
This study is a stack
Sagittal T1
C+ fat sat
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Info

30 x 40 x 55 mm midline rim enhancing fluid signal collection associated with edema throughout the lower gluteal region superficial to the coccyx (first and second coccygeal segments)  and distal sacrum (S1). 

An enhancing sinus tract is present that terminates in the lower intergluteal cleft distal to the level of the last coccygeal segment.

Decreased T1 and hyperintense T2 fat suppression signal present throughout the remainder of the coccyx (with destruction) and in the S5 body.

Case Discussion

The MRI imaging findings represent osteomyelitis of sacrococcygeal and pericoccygeal soft tissue collection.

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