Left hip pain after fall. Inability to ambulate. The marrow signal intensity of the left proximal femur is normal. There are tiny foci of abnormal signal intensity in the acetabular dome which I suspect are degenerative in etiology. There is a small amount of fluid in the left hip joint, within normal limits. I see no focal injury to the musculature of the left hip.There is extensive signal abnormality noted within the upper sacrum on the large field-of-view images. The right sacral wing is largely replaced with low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. There is a bandlike focus of low signal intensity extending vertically through the right sacral wing suggesting an underlying nondisplaced fracture. Similar but slightly less pronounced signal abnormality is noted in the left sacral wing, with findings suggestive of a nondisplaced fracture.Degenerative disc disease affects the lower lumbar spine. Mild osteoarthritis affects the pubic symphysis. There is mild edema-type signal within the subcutaneous fat of the buttocks bilaterally which is nonspecific but could represent a mild contusion.
1.No evidence of fracture of the left proximal femur or acetabulum.2.Extensive signal abnormality in the upper sacrum is suggestive of nondisplaced fractures involving both sacral wings. I am not certain if these fractures are due to the patient's recent fall or represent insufficiency fractures, but I suspect the former given the degree of edema. Further evaluation with CT may be considered, if clinically warranted. Per the electronic medical record, the patient has been admitted to the hospital. Findings were relayed over the phone to Vanessa Alonso at the time of dictation.