Reason: 60 year male history of myelofibrosis status post allogenic stem cell transplant with cGVHD and chronic steroid use, increased left hip pain. Evaluate for fracture vs. osteonecrosis vs. possible joint effusion History: left hip pain, inability to weight bear on LLE. Decreased signal intensity in the visualized lower lumbar spine, sacrum, and pelvis compatible with stated history of myelofibrosis, appearing similar to that seen on prior exam. Nodular foci of low signal intensity within the proximal femora also likely represent manifestation of myelofibrosis, also appearing similar to prior. Additionally, there is poorly defined edema type signal intensity within the left acetabular dome that enhances following gadolinium administration. There is suggestion of a curvilinear band of low signal intensity within this edema suggesting the possibility of a stress fracture or perhaps early osteonecrosis. The poor definition of the edema as well as small foci of interspersed fat signal intensity argue against neoplasm.Mild osteoarthritis affects both hips, but we see no evidence of avascular necrosis of either femoral head.Mild edema type signal intensity along the pubic symphysis likely is degenerative in etiology.Degenerative disc disease affects the visualized lower lumbar spine.There is perhaps slightly more fluid in the left hip joint relative to the right hip joint, but we see no large effusion.Mild muscular atrophy; we see no soft tissue masses.
1.Findings compatible with myelofibrosis.2.Poorly defined signal abnormality and enhancement in the left acetabulum is nonspecific, although may represent a stress fracture or perhaps early osteonecrosis. The absence of a well-defined lesion and the presence of small foci of fat signal intensity argue against neoplasm.