71-year-old female with metastatic breast cancer to the liver and bone with increased right hip pain. Please evaluate for fracture. BONE MARROW: Note is made of increased bone marrow signal abnormality within the right inferior and superior pubic rami with associated enhancement on postcontrast sequences consistent with metastatic disease. There is cortical irregularity and linear low signal abnormality traversing the right inferior and superior pubic rami suspicious for minimally displaced pathologic fractures. Additionally note is made of multiple additional foci of signal abnormality in the right iliac bone and right superior acetabulum suspicious for osseous metastatic disease. There is linear low signal abnormality traversing the superior right acetabulum suspicious for a nondisplaced pathologic fracture. There are additional foci of enhancing signal abnormality within the base of the femoral neck and intertrochanteric region consistent with osseous metastatic disease involving approximately 50% of the width of the base of the femoral neck. No acute fracture is identified, as clinically questioned. There are compression fractures affecting the vertebral bodies of the imaged lower lumbar spine, which are incompletely imaged, with associated increased signal abnormality on fluid sensitive sequences, suspicious for pathologic fractures. Please see the accompanying MRI lumbar spine report for additional details.SOFT TISSUES: Note is made of increased signal abnormality within the gluteal musculature bilaterally which is nonspecific although a subacute denervation injury cannot be excluded. The remainder of the imaged musculature is normal in appearance.JOINTS: The right hip joint alignment is anatomic. Moderate degenerative changes affect the right hip.ADDITIONAL
Multifocal osseous metastatic disease with pathologic fractures involving the lower lumbar spine, right superior acetabulum, as well as the right superior and inferior pubic rami. There is osseous metastatic disease affecting the intertrochanteric region of the right femur without convincing evidence of an acute fracture, as clinically questioned. Other findings as described above.