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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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MRI Shows Femoral Head And Neck Lesion With Fluid Collection. Prescribed AKT-4, Oflin. Treatment?

MRI of Left HIP Joint
Procedure : Coronal = T1, T2 and Fat suppressed T2,
Axial = T2 and PD.
Sagittal = T2 and PD.
Findings :
Abnormal signal intensity showing T1 & T2 lengthening is seen involving the head & neck of left femur. Fluid collection is seen in left hip joint space and in its peri-articular location.
Joint capsule and surrounding ligaments are normal in signal intensity.
Acetabulum is normal in signal intensity.
Muscle and tendons shows normal signal intensity.
Subcutaneous fat shows normal signal intensity.
Pelvic cavity revealed no significant abnormality.
Right hip joint showed no significant abnormalities.
Sacroiliac joints are normal.

Impression :

MRI study revealed : Left femoral head & neck lesion with intra- & peri-articular fluid collection.------- ? Infective.

Mycobacterium Complex - PCR (Peripheral Blood)
Mycobacterium genus (MOTT) Not Detected
Mycobacterium tuberculosis Not Detected

My doctor suggest me Tab AKT-4
Tab Oflin (400)
Tab Zincovit
Tab B-long for 6-8 weeks daily
please suggest me the right way for treatment.
Tue, 13 Aug 2013
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Internal Medicine Specialist,  's  Response
Hi,
Welcome to healthcare Magic!
The MRI findings of the hip are suggestive of an inflammatory process most likely due to tuberculosis.
But the PCR for TB is negative. Actually the blood PCR is not ideal test in your case. You should have got a synovial fluid sample from the from the affected joint and investigated for PCR- TB and MOTT and cytology, proteins, sugar, gram stain and c/s test should be done. The joint fluid PCR is a more useful test than blood PCR.
Starting ATT is worthwhile but make sure the cultures and the advised sampling is done preferably before any antibiotic treatment.
I hope the advise would be informative and useful for you.
Take Care!
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MRI Shows Femoral Head And Neck Lesion With Fluid Collection. Prescribed AKT-4, Oflin. Treatment?

Hi, Welcome to healthcare Magic! The MRI findings of the hip are suggestive of an inflammatory process most likely due to tuberculosis. But the PCR for TB is negative. Actually the blood PCR is not ideal test in your case. You should have got a synovial fluid sample from the from the affected joint and investigated for PCR- TB and MOTT and cytology, proteins, sugar, gram stain and c/s test should be done. The joint fluid PCR is a more useful test than blood PCR. Starting ATT is worthwhile but make sure the cultures and the advised sampling is done preferably before any antibiotic treatment. I hope the advise would be informative and useful for you. Take Care!