Female 60 years old with worsening back and hip pain and known metastatic breat cancer to spine and hip s/p radiation. There are multiple metastatic deposits. A lesion in the right iliac wing is approximately 4.3 x 3.3 x 1.3 cm (series 4, image 12 and series 3, image 14) and is associated with cortical destruction. 2 lesions are also noted in the left iliac wing, the larger of the 2 lesions measures 2.9 x 2.3 x 1.6 cm (series 4, image 8 and series 5, image 13) and also results in cortical destruction. There is mild edema within the adjacent musculature on both sides. Several lesions are also noted in the proximal right femoral diaphysis, one of which is cortically based beneath the lesser trochanter. This lesion measures just over 1 cm in diameter (series 5, image 45) and 3 cm in length (series 6, image 12). A similar but smaller lesion is noted in the subtrochanteric left femur.The hip joints appear normal. Degenerative arthritis affects the lower lumbar spine; please refer to the separately dictated report for the lumbar spine MRI for further details. There is small amount of free fluid within the pelvis. Heterogeneous nodular and reticular signal abnormality in the fat of the buttocks likely represents fibrosis and/or fat necrosis from prior injections.
Metastatic disease of the pelvis and proximal femora as above.