Splenic mass. Pelvic pain. Consultation with Dr. Peabody reveals an additional history of prior breast cancer.IMAGE ACQUISITIONS: Nonenhanced computed tomography of the pelvis with transverse, coronal, and sagittal reformatted images provided. There is sclerosis of the left ischium and supraacetabular left ilium that appears similar to prior studies and corresponds to abnormal signal intensity seen on an outside MRI examination. Subtle abnormal density of the L5 vertebral body is also noted, but the corresponding lesion is better visualized on the prior lumbar spine MRI examination. There are also chronic fractures of the superior ramus and body of the left pubic bone. A fracture of the left sacral wing is new when compared to prior studies. Moderate osteoarthritis affects both hip joints. Severe degenerative disk disease affects the visualized lower lumbar spine.There is atherosclerotic calcification of the distal abdominal aorta and common iliac arteries. The pelvic viscera are unremarkable given the limitation imposed by lack of intravenous or enteric contrast.
1. Sclerotic lesions in the left ischium and supra-acetabular ilium as described above which correspond to areas of abnormal signal intensity on MRI. Given the patient's history of breast cancer, metastases cannot be excluded.2. Fractures and degenerative arthritis as described above.