[image: 77F Rt Sacral Lesion.jpg]
Current Pelvis MRI in a 77yo F with 1 year low back and bilateral leg pain
The referrer is very worried about the lesion in the Rt Sacral Ala…I
reported what I think…but I told her I would get “second” opinions.
I promised to follow up with her today….please tell me what you think.
[image: 77F Rt Sacral Lesion (1).jpg]
[image: 77F Rt Sacral Lesion (2).jpg]
[image: 77F Rt Sacral Lesion (3).jpg]
[image: 77F Rt Sacral Lesion (4).jpg]
[image: 77F Rt Sacral Lesion (5).jpg]
[image: 77F Rt Sacral Lesion (6).jpg]
1 thought on “77F chronic LBP and leg pain with Sacral Lesion worrying the referrer”
hilary.umans
Thanks to all who have responded…..I think you all realized that I needed
your assistance to reassure a nervous referrer.
She is very smart…I suspect she might have some personal connection to
the patient…..and the prominence of the cystic changes in the
sacrum—combined with her age and inherent risk for all-things-bad got her
particularly nervous.
The fact that there was complete agreement among a broad cross-section,
without telling you what I reported, has settled the matter.
This is simply very severe facet arthrosis, worse on the right—-with
extensive degenerative cystic changes extending into the right sacrum.
A few of you recognized the DISH related fusion of the upper SI joints,
which is likely conferring more stress on the lower lumbar facet joints.
She also has stress related marrow edema in the posterior
elements….bilaterally, but worse on the right—-though, if you look at
the prior lumbar MRI, it has improved a bit on the left side.
Apologies for having used you to simply persuade a nervous referrer….but
it has saved an old woman unnecessary additional imaging studies and
medical consultations.
your assistance to reassure a nervous referrer.
She is very smart…I suspect she might have some personal connection to
the patient…..and the prominence of the cystic changes in the
sacrum—combined with her age and inherent risk for all-things-bad got her
particularly nervous.
The fact that there was complete agreement among a broad cross-section,
without telling you what I reported, has settled the matter.
This is simply very severe facet arthrosis, worse on the right—-with
extensive degenerative cystic changes extending into the right sacrum.
A few of you recognized the DISH related fusion of the upper SI joints,
which is likely conferring more stress on the lower lumbar facet joints.
She also has stress related marrow edema in the posterior
elements….bilaterally, but worse on the right—-though, if you look at
the prior lumbar MRI, it has improved a bit on the left side.
Apologies for having used you to simply persuade a nervous referrer….but
it has saved an old woman unnecessary additional imaging studies and
medical consultations.
Hilary
On Thu, Jan 13, 2022 at 11:13 AM hilary umans <hilary.umans@gmail.com>
wrote:
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