FIG 2.

Aspergillus osteomyelitis and arthritis. A 52-year-old male with lymphoblastic lymphoma and a history of pulmonary aspergillosis developed pain in the left hip. MRI showed a femoral head lesion and avascular necrosis. After another cycle of chemotherapy, he was admitted to the hospital with a worsening of chronic left-hip pain and limited range of motion. (Left) A plain radiograph showed bone destruction, osteolysis of the left femoral head, and a decrease in the left articular space. (Middle and right) MRI showed a 3.8- by 2.1-cm oval mass in the anterior medial inferior left femoral head with a low T1 intensity (middle) and a high signal intensity with T2 (right), extending into the neck of the femur, with a well-defined border. There was moderate left-hip effusion and abnormal T2 hyperintensity in muscles around the left hip. A left-hip aspirate smear demonstrated hyphae by microscopy and grew Aspergillus flavus in culture.