Gluteal Injection Site Granuloma

Demographic and clinical details: 52 years old female, with a low back pain

Image Details;  AP radiograph of pelvis (a) shows sclerosis at inferior iliac side of the bilateral sacroiliac joints (white arrows) consistent with osteitis condensans ilii (OCI). Note the multiple loose bodies like calcification (black arrow) at superior periarticular region of left hip joint which resembles to the loose bodies of synovial osteochondromatosis. T1-weighted MR (d)  and CT images of the axial plane shows that the calcified nodules seen on pelvis radiography (a) is consistent with gluteal injection site granulomas (GISG)

GISG is a very common finding on CT and direct Xray’s of pelvis. They generally occurs as result of subcutaneous fat tissue injection of drugs resulting in granuloma formation and and account focal fat necrosis, scar formation and dystrophic calcification.

In my experience,   GISG  can be seen incidentally on pelvis radiographies like in our case,  ıt can looks like articular-periarticular loose bodies of synovial osteochondromatosis when evaluated with just one plane radiograph. That is why evaluation with at least  two  view radiography or cross-sectional imaging methods  like CT or MRI are recommended for the exact localization and correct diagnosis of musculoskeletal pathologies.