MVC with back pain. Assess for acute process. Per the on call radiology resident memo, the patient also has a history of breast cancer with diffuse osseous lesions. Thoracic spine: There are multiple poorly defined lucent lesions involving the thoracic spine and ribs compatible with the stated history of metastatic breast cancer. There are multiple vertebral body compression fractures which I presume to be pathologic in nature, most notably affecting T4, T7, and T9-T12. While I suspect that most if not all of these are chronic, I cannot ascertain whether or not any individual compression fracture might be due to the patient's recent MVC. In addition to numerous rib lesions, multiple sites of rib deformity represent healing or healed fractures. Although the cervical spine is not optimally evaluated on these thoracic spine radiographs, on the swimmer's view there is suggestion of loss of height of the C4 and C5 vertebral bodies, which I suspect is pathologic in nature; please refer to the subsequent cervical spine MRI report for additional information. Poorly defined left lung basilar opacity is nonspecific and would be better evaluated with dedicated chest radiographs if clinically warranted. There is a right-sided central venous access device with its tip in the right atrium.Lumbar spine: Diffuse metastatic disease affects the lumbar spine. There is severe compression deformity of L3 and moderate compression deformities of L1 and L2, which I suspect are chronic. Facet joint osteoarthritis affects the lower lumbar spine.Pelvis: There is diffuse metastatic disease involving the bones of the pelvis with additional lucent lesions involving the proximal femora. Deformity of the right ischiopubic junction likely represents an old healed fracture; however, I see no acute fracture on this study.
Widespread metastatic disease to bone with multiple cervical, thoracic, and lumbar spine compression fractures as described above.