<s>[INST] Hi, I have cirrhosis of the liver . Fatty Liver and progressed to NASH then onto cirrhosis. I have diabetes that has been controlled for 1 year now. I have a ultrasound every year and the results have been pretty much the same until now . My Dr. has asked me to come in and discuss the findings this time. It looks like it has progressed. I have a copy that was sent to me and I have a question about what this statement might mean . The liver measured 17.7 cm in length (previously 15.8cm) with a coarsely heterogenesous echotexture. The liver edge is again noted to be lobulated in appearance consistent with cirrhosis. the spleen measured 11.1 cm in length (previously 12.3cm ). I am have terrible back pain below my rib cage. Can this really be liver pain that is radiating to my back ? [/INST] Hiwith these finding in the ultrasound abdomen added in the back pain, it is better to go for a CT abdomen & pelvis. Followed by MRI spine (TOTAL OR HORACE LUMBAR)so that any serious issues should not be missed. Coarse heterogeneous liver with cirrhosis- it is better to rule out any malignancy relative stages or any secondaries which could have spread to the spine or receivers. CONFIRMING THE CAUSE IS BETTER.all the best, take care </s>