MGUS, evaluate for myelomatous lesions The medullary bone of the lower lumbar spine, pelvis, and proximal femoral demonstrates heterogeneous signal intensity likely representing residual red marrow. An subcentimeter focus of heterogeneous T1/high T2 signal is noted within the posterior column of the left acetabulum. Although this could conceivably represent a small myelomatous deposit, the lesion demonstrates small foci of hyperintense signal on T1-weighted images, and therefore may simply represent a small cartilaginous rest. There is a more discrete focus of intermediate signal intensity within the left subtrochanteric femur measuring approximately 1 cm. This is favored to represent a small island of red marrow although a small myelomatous lesion cannot entirely be excluded. Mild peritrochanteric edema is noted which is not necessarily of any clinical significance. The signal intensity of the pelvic musculature is normal. A small amount of fluid is noted within both hips, probably within normal limits.A left-sided vaginal cyst is noted demonstrating which demonstrates high T1 signal likely reflecting the presence of proteinaceous material.
Subcentimeter foci of abnormal signal intensity within the posterior column of the left acetabulum with an additional 1 cm focus of intermediate signal within the left subtrochanteric femur. These findings are thought to most likely represent benign etiologies (such as a cartilaginous rest and an island of red marrow respectively); however the presence of small myelomatous deposits cannot entirely be excluded. Serial MR imaging can be obtained as clinically warranted.