A 29 year old Caucasian female with a history of intravenous drug use presents with one week of worsening right hip and back pain, subjective fevers, chills, and lower back pain. Magnetic Resonance (MR) of the bilateral hips was performed (Fig. 1).

Fig. 1
figure 1

a: Axial T1 weighted MR image of the bilateral hips. b: Axial T2 weighted MR image of the bilateral hips. c: Axial T1 fat-suppressed pre-contrast and post-contrast MR image of the bilateral hips. d: Digital Subtraction Angiography of the Left Gluteal Arteries performed 1 day after the MRI. e: Contemporaneous sagittal greyscale and corresponding color Doppler ultrasound images of the left buttock