Sclerotic bone lesion workup/managment Q.
Would love any advice on additional imaging/workup for my patient. MRI as below with…been reading up on ddx and workup for sclerotic bone lesions pretty broad.
Do you punt these back to surgeons or workup these up yourselves? I haven’t come across this a whole lot yet. Relatively new attending.
MRI L Spine with contrast
1. Bone marrow is heterogeneous. There is a stable area of low t1 and T2 weighted signal at l4. The focal signal at L3 is likely present although slightly less defined on current exam. Remaining marrow somewhat heterogeneous. These are nonspecific and likely related to some sclerotic bone lesions.
2. Bilateral iliac nodes are seen on the right recommend clinical correlation. Correlate with bone scan as clinically indicated. Estimated to measure 11mm. On the left measuring up to 9 mm. Correlated with Ct/ABD pelvis clinically indicated
3. Minimal anterior spondylolishesis on l4on l5 from facet arthropathy no canal stenosis is seen. Mild narrowing of the foramen is noted
4. Dis desiccation and small bulges At L1-L4 with no neural compromise
CT AB pelvis
-Unremarkable CT study of abd pelvis.
Would love any advice on additional imaging/workup for my patient. MRI as below with…been reading up on ddx and workup for sclerotic bone lesions pretty broad.
Do you punt these back to surgeons or workup these up yourselves? I haven’t come across this a whole lot yet. Relatively new attending.
MRI L Spine with contrast
1. Bone marrow is heterogeneous. There is a stable area of low t1 and T2 weighted signal at l4. The focal signal at L3 is likely present although slightly less defined on current exam. Remaining marrow somewhat heterogeneous. These are nonspecific and likely related to some sclerotic bone lesions.
2. Bilateral iliac nodes are seen on the right recommend clinical correlation. Correlate with bone scan as clinically indicated. Estimated to measure 11mm. On the left measuring up to 9 mm. Correlated with Ct/ABD pelvis clinically indicated
3. Minimal anterior spondylolishesis on l4on l5 from facet arthropathy no canal stenosis is seen. Mild narrowing of the foramen is noted
4. Dis desiccation and small bulges At L1-L4 with no neural compromise
CT AB pelvis
-Unremarkable CT study of abd pelvis.
