Pathologic fracture Examination is limited by motion artifact. Multiple repeat sequences were attempted.A large destructive lesion of the right iliac wing is seen consistent with known history of pathologic fracture. Abnormal marrow signal involves the majority of the right iliac wing as well as the SI joint and inferior acetabulum.Evaluation of the sciatic nerve is markedly limited by motion artifact and by the abnormal signal intensity detailed above. The proximal portion of the sciatic nerve is seen however the course of the nerve is obscured at the level of the sacroiliac joints and near the area of pathologic fracture. What is thought to represent the sciatic nerve appears slightly increased in signal intensity although this may be reactive in nature. The distal portion of the sciatic nerve at the level of the femoral head/neck appears intact.There is diffuse soft tissue edema and enhancement, likely reactive in nature. Abnormal marrow signal within the right femoral head suspected to represent avascular necrosis.
1. Large destructive lesion of the right iliac wing consistent with known history of metastatic disease and pathologic fracture.2. Abnormal marrow signal throughout the right hemipelvis likely reflects a combination of metastatic disease and postradiation change.3. Limited evaluation of the sciatic nerve at the level of the pathologic lesion secondary to extensive motion artifact and abnormal surrounding signal intensity although the distal portion of the nerve appears intact.4. Avascular necrosis of the right femoral head.