Reason: hx aml s/p allogenic stem cell transplant on long term steroids for GVHD. Hx osteoporosis History: bilateral groin pain, increased pain with weight bearing There is abnormal signal intensity and deformity within the inferior pubic rami bilaterally indicating mildly displaced fractures. There is a small collection of abnormal signal intensity and enhancement within the left obturator externus muscle adjacent to the left inferior pubic ramus fracture perhaps representing hematoma formation and associated inflammatory changes. There is also bandlike signal abnormality extending through the superior pubic rami bilaterally indicating additional nondisplaced fractures. There is mild edema and enhancement of the soft tissues adjacent to the fracture of the left superior pubic ramus. There is also bandlike signal intensity extending transversely through the posteromedial aspect of the right iliac wing indicating a fracture with edema in the surrounding marrow. There is mild edema and enhancement of the adjacent soft tissues. There is also branching signal abnormality within the left sacral wing abutting the first and second neuroforamina indicating a fracture with surrounding marrow edema and enhancement. There is also branching low signal intensity on T1-weighted images within the medial aspect of the left femoral neck likely representing a chronic fracture; there is no edema or enhancement to suggest an acute injury. There is also patchy intermediate signal intensity within the femoral diaphyses bilaterally. This is nonspecific and may simply represent treatment effect; leukemic infiltration is considered less likely due to lack of significant contrast enhancement.. Mild osteoarthritis affects both hips. Moderate to severe degenerative disc disease affects L5/S1.
Multifocal signal abnormalities as described above likely representing stress fractures of varying ages.