I have been reassured by Rob Lambert that it is neither sinister, nor does it suggest any obvious metabolic bone disorder…so I’m over it.
I had wondered if it could be due to chronic mechanical stress at the insertion of the abdominal wall muscles, given the awful condition of his lumbar spine and his body habitus…this was echoed by Bonner Guilford, who has seen it before, and Rob agrees, so that’s what I’m going with.
Thank to everyone who commented
The AP is positioned as an outlet view, presumably because of his severe DDD and considerable belly
What is going on with the superior rami? Is that cortical erosion / resorption? The SIJs look normal, his hips look normal.
I wonder if you can explain it?
Tell me if there is any reason to recommend additional imaging.
I suspect the hip pain is from his severe DDD and facet arthrosis.
