Patient History: 62-yo male with right hip pain, weakness, and low back pain.
Findings
SKELETAL: Abnormal signal within the right ischium, inferior pubic ramus, right anterior acetabulum. Infiltration of the surrounding soft tissues. No displaced pathologic fracture. Cortical buckling of the right inferior pubic ramus compatible with nondisplaced fracture of indeterminate age.
PELVIS: Colonic diverticulosis. No free fluid. No hernia.
JOINTS: Mild right femoroacetabular joint space loss and anterolateral labral fraying.
ACETABULUM/LABRUM: Mild labral fraying.
MUSCLES/TENDONS/LIGAMENTS: Right hamstring origin tendinosis and ventral surface fraying without rupture. Normal right iliopsoas. Normal right gluteus medius and minimus insertions.
OTHER/SOFT TISSUE: No lymphadenopathy.
Conclusion
1. Infiltrative destructive lesions within the right anterior acetabulum and right ischium extending into the right inferior pubic ramus. Nondisplaced age-indeterminate right inferior pubic ramus fracture. Infiltration and swelling in the surrounding soft tissues but no sign of discrete mass. Findings compatible with metastatic disease or myeloma.
2. Mild right femoroacetabular joint space loss and acetabular labral fraying.
3. Mild right hamstring tendinosis and ventral surface fraying without tear.
4. Colonic diverticulosis.
