case_images: PMC9244921_01
case_images: Images (a), (b) and (d) demonstrated an irregular regiment at the right wing of iliac (triangles) with hyperintense on PDWI [(a) and (b)] and obvious enhancement (d), further attached to the erector spinae, iliopsoas and gluteus, appeared as widespread myofascitis [black arrows in (a), (b), (d) and (e)]. MRN showed inhomogeneous and focal hyperintense in LS plexus [yellow arrows in (e)] and mild fusiform hypertrophy in the right L5 nerve root (triangles). Enhancements were observed in bilateral nerve roots [arrows in (f)] and cauda equina [arrows in (g)]. Normal performance in the brachial plexus (c)
case_images: 10.1177_17562864221106350-fig1.jpg
case_images: PMC9244921_01_10.1177_17562864221106350-fig1.jpg
case_images: fig1-17562864221106350
case_images: Mild enhancements were observed in the cauda equina and LS plexus nerve roots, and this was accompanied by the effusion and swelling perineurium (Figure 1).
case_images: PMC9244921_02
case_images: MRN showed an irregular greatly mass at right sacroiliac joint, with hyperintense on T2WI [triangles in (a) and (e)], isointense on unenhanced T1WI [triangles in (b)], and uniform enhancement after gadolinium administration [triangles in (d)]. Cortical disruptions were detected with involvement of sacroiliac joint [triangles in (b), (d) and (e)]. Affected right L5-S1 nerve roots [yellow arrows in (a)-(e)] were detected as swelling and mild hypertrophy with effusion perineurium (a), accompanied by extensive lumbar gluteal myofascitis [black arrows in (a), (c), and (e)]. MRN showed heterogenous signal intensity in the brachial plexus (f) with focal hyperintense in nerve roots and branches (arrows). Image G showed mild enhancement in the cauda equina [arrows in (g)].
case_images: 10.1177_17562864221106350-fig2.jpg
case_images: PMC9244921_02_10.1177_17562864221106350-fig2.jpg
case_images: fig2-17562864221106350
case_images: Furthermore, we detected heterogeneous enhancements were detected in the bone mass, as well as the nerve roots and cauda equina after gadolinium administration (Figure 2).
case_images: PMC9244921_03
case_images: MRN revealed symmetrical diffuse hypertrophy with heterogenous increased signal intensity and mild enhancement, markable effusions of perineurium in the LS plexus [yellow arrows in (a)-(c)], brachial plexus [(e) and (f)] and its branches. Neural stems exhibited the worm-like signal reductions in LS [triangles in (c)] and brachial plexus [triangles in (f)]. A markable wide range of myofascitis and atrophy in denervated lumbar gluteal muscles were detected [black arrows in (a), (c) and (d)]. Image D showed a subtle bone lesion with hyperintensity on T2WI in the sacroiliac bone (yellow arrow).
case_images: 10.1177_17562864221106350-fig3.jpg
case_images: PMC9244921_03_10.1177_17562864221106350-fig3.jpg
case_images: fig3-17562864221106350
case_images: Results from MRI skeletal survey revealed multiple subtle lesions with hyperintensity on T2WI within the sacroiliac bone (Figure 3).