Hello everyone,
I'm looking for some insight regarding bone imaging and bone lesions.
I have been having hip pain on and off for the past 11 months, some of which I know has been related to activity.
I have been followed by an orthopedic. I had an MRI done about 4 months ago. After reading it, he wasn't concerned, but due to the continued pain decided on a new X-ray.
After reading the second X-ray, he seemed very concerned and ordered a STAT MRI and wanted me to be non-weight bearing using crutches and thought I should change my vacation plans. We were headed out that night to start our family vacation in the Smoky Mountains. He explained there was a lesion detected on the right femoral head and wanted the MRI to rule out a stress fracture.
The MRI was done and shows no lesion or indication of stress fracture in the right hip. However, from the large view of the left (opposite) hip, a benign lucent lesion was detected as well as exaggerated hematopoietic bone marrow in the bilateral proximal femurs.
Can an MRI miss a lesion that comes up on X-ray?
Can the benign lucent lesion be a result of myeloma?
Can the findings within the marrow be any indication of disease activity?
I have had no lesion history in the past. I'm not followed by my M-spike and have been in a partial response (PR) to a very good partial response (VGPR) since transplant 2 years ago.
I'm not due to see my myeloma specialist till the end of next month. Any thoughts or experiences would greatly be appreciated.
Thanks,
Jen
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4 posts
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Jbodnar - Name: Jen
- Who do you know with myeloma?: Myself
- When were you/they diagnosed?: 2012
- Age at diagnosis: 45
Re: Making sense of x-ray & MRI results
Jen,
This seems like something that should really be addressed by the medical professionals.
Like you, bone damage and catching it early and stopping it before it becomes a problem that affects my otherwise good quality of life permanently is something I am always concerned about. I do not know that you could extrapolate or relate mine or anyone else’s experience to your particular case, though. I would think that some of your questions regarding the lesions could be addressed by a radiologist and/or your orthopedic.
Best of wishes and hope this is nothing serious.
This seems like something that should really be addressed by the medical professionals.
Like you, bone damage and catching it early and stopping it before it becomes a problem that affects my otherwise good quality of life permanently is something I am always concerned about. I do not know that you could extrapolate or relate mine or anyone else’s experience to your particular case, though. I would think that some of your questions regarding the lesions could be addressed by a radiologist and/or your orthopedic.
Best of wishes and hope this is nothing serious.
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Eric Hofacket - Name: Eric H
- When were you/they diagnosed?: 01 April 2011
- Age at diagnosis: 44
Re: Making sense of x-ray & MRI results
Hello Jen!
Yes, an MRI can pick up bone lesions long before they are seen with plain x-rays.
The word "benign" means that the lucent lesion is not suggestive of myeloma and it is therefore due to some other cause, like previous trauma.
The radiologist did not feel that the findings in the femurs were suggestive of disease activity or he / she would have stated this. Myeloma patients often have changes in their marrow appearance by MRI from treatment, e.g. chemotherapy.
The MRI sounds like good news to me. No new lesions or destruction.
Have a great weekend Jen.
Yes, an MRI can pick up bone lesions long before they are seen with plain x-rays.
The word "benign" means that the lucent lesion is not suggestive of myeloma and it is therefore due to some other cause, like previous trauma.
The radiologist did not feel that the findings in the femurs were suggestive of disease activity or he / she would have stated this. Myeloma patients often have changes in their marrow appearance by MRI from treatment, e.g. chemotherapy.
The MRI sounds like good news to me. No new lesions or destruction.
Have a great weekend Jen.
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Dr. Edward Libby - Name: Edward Libby, M.D.
Beacon Medical Advisor
Re: Making sense of x-ray & MRI results
Hello, Jbodnar!
I am wondering whether you ever found an answer to your question: can an MRI miss a lesion that shows up on an x-ray? Dr. Libby does not appear to have answered this question in his response to you.
A few months ago, with my myeloma markers in fine shape, I started experiencing intermittent pain in my left clavicle bone. At the same time, I was also feeling a low grade intermittent pain in one of my ribs (also on the left side). This latter pain had started more than a year and a half ago and at that time was determined to be a sclerotic lesion ( thickening of the bone) perhaps associated with a bad cough I had developed.
With respect to the clavicle pain, my oncologist ordered an x-ray which determined that I had a small sclerotic lesion on the clavicle that did not need further attention. A few weeks later, my myeloma specialist thought that since my last PET/CT scan had been over a year ago, I should have new imaging. She gave me the choice between a PET and a full body MRI. I chose the latter because of radiation concerns.
My MRI results mentioned absolutely nothing about any lesions on my clavicle or my rib, much to my surprise. So, I have been wondering, much as you did back in April, whether an MRI can miss bone lesions detected by x-ray or PET scan. Since the pains I had complained about continued subsequent to my MRI, I assume that whatever was causing them was present at the time the new imaging was done.
Another question I have (which I hope someone in the community can answer) is what is the import of a sclerotic bone lesion? No one seems too concerned about mine, but it strikes me that any such lesion cannot be exactly normal. One poster wrote in a few weeks ago telling us that she had a very rare form of myeloma that involved sclerotic bone lesions, but she seemed to have complications that up to now I have not had.
I am wondering whether you ever found an answer to your question: can an MRI miss a lesion that shows up on an x-ray? Dr. Libby does not appear to have answered this question in his response to you.
A few months ago, with my myeloma markers in fine shape, I started experiencing intermittent pain in my left clavicle bone. At the same time, I was also feeling a low grade intermittent pain in one of my ribs (also on the left side). This latter pain had started more than a year and a half ago and at that time was determined to be a sclerotic lesion ( thickening of the bone) perhaps associated with a bad cough I had developed.
With respect to the clavicle pain, my oncologist ordered an x-ray which determined that I had a small sclerotic lesion on the clavicle that did not need further attention. A few weeks later, my myeloma specialist thought that since my last PET/CT scan had been over a year ago, I should have new imaging. She gave me the choice between a PET and a full body MRI. I chose the latter because of radiation concerns.
My MRI results mentioned absolutely nothing about any lesions on my clavicle or my rib, much to my surprise. So, I have been wondering, much as you did back in April, whether an MRI can miss bone lesions detected by x-ray or PET scan. Since the pains I had complained about continued subsequent to my MRI, I assume that whatever was causing them was present at the time the new imaging was done.
Another question I have (which I hope someone in the community can answer) is what is the import of a sclerotic bone lesion? No one seems too concerned about mine, but it strikes me that any such lesion cannot be exactly normal. One poster wrote in a few weeks ago telling us that she had a very rare form of myeloma that involved sclerotic bone lesions, but she seemed to have complications that up to now I have not had.
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