40-year-old female with metastatic non-small cell lung carcinoma. Note is made of heterogeneous bone marrow signal which likely represents residual islands of red marrow. The foci of decreased bone marrow signal abnormality on T1 weighted images are hyperintense to skeletal muscle. No enhancing mass lesions are identified. The imaged musculature of the pelvis appears normal. Linear focus of signal void within the vagina consistent with a tampon. 4.3 cm right adnexal cystic lesion is likely physiologic in a menstruating patient of this age. Facet joint osteoarthritis affects the lower lumbar spine. Mild degenerative disc disease affects the imaged portion of the lower lumbar spine.
No evidence of osseous metastatic disease affecting the sacrum, as clinically questioned. The patient was called back for this additional imaging and will not be billed for this examination. 