Spine pain. Evaluate for compression fracture. Patient on chronic high-dose steroids. Thoracic spine: The bones are diffusely demineralized, suggesting osteopenia or osteoporosis. Anterior wedging of multiple thoracic vertebral bodies and severe compression deformity of T9 appear grossly stable from prior CT. There is resultant marked kyphosis of the thoracic spine. No obvious acute fracture is present.Lumbar spine: The bones are diffusely demineralized, suggesting osteopenia or osteoporosis. Anterior osteophytes and mild multilevel degenerative disc disease are noted. Lucency of the left L4 pedicle is questioned, raising the possibility of age-indeterminate fracture, not present on prior MRI. The left L4 transverse process is also not well visualized. CT of the lumbar spine can be considered for further evaluation.Pelvis: The bones are diffusely demineralized, suggesting osteopenia or osteoporosis. Linear lucency and sclerosis of the right pubis/inferior pubic ramus may represent acute to subacute fracture. Mild degenerative changes affect the sacroiliac joints and left hip joint.
1.Multiple thoracic vertebral compression fractures, likely chronic. 2.Questionable age-indeterminate left L4 pedicular fracture; CT may be considered for further evaluation. 3.Right pubis/inferior pubic ramus fracture, likely acute to subacute.Findings were discussed via telephone with Dr. Curran at 1:33 PM on 8/13/2015.