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MRI showed diffuse abnormal T1 hypo intense/T2 hyperintense, acetabulum, ishium and pubic bone. Concerned

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Practicing since : 1978
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Had an MRI done on my left hip yesterday due to some pain in the joint. The MRI report states that There is diffuse abnormal T1 hypo intense/T2 hyperintense signal of the bone marrow of the left ilac bone, acetabulum, ishium and pubic bone.

I am scheduling an appointment with an oncologist tomorrow for the biopsy. Do these things usually end up being nothing or should I be very worried? What can cause this type of MRI result if it's not cancer? I have zero symptoms of cancer and my blood work was done 4 months ago and it was fine.

Here are the findings:

Differential diagnoses are led by infiltrating marrow disease, such as leukemia, lymphoma or less likely a multiple myeloma with possible extra-osseous infiltrating extension of disease versu reactive hyperenia, as etiology for the periosteal bone edema and surrounding intramuscular edernatious signal verus much less likely, osteomyelitis with inflammatory-related periosteal bone edema and secondary myositis of the surrounding muscles. Clinical correlation needed. Consider bone biopsy for histological diagnosis, as clinical circumstances warrant.
Posted Thu, 29 Nov 2012 in Bones, Muscles and Joints
Answered by Dr. Pavan Kumar Gupta 4 hours later
Thanks for the query.
Although such hypotense and hyperintense signal are a cause for concern but one should not be unduly worried about them because there are several benign conditions which result in necrosis,fibrosis,inflammation,hemorrhage etc in bone marrow or surrounding soft tissue structures besides Lymphoma or leukemia or multiple myeloma etc.
These benign pathologies give the same radiological findings as of malignant lesions and that's the reason, biopsy becomes absolutely essential to pinpoint the exact cause.

Please carry on with your date with your oncologist and get the biopsy done.

Please do revert to me if there is any other concern or query.
Best of luck
Above answer was peer-reviewed by
Follow-up: MRI showed diffuse abnormal T1 hypo intense/T2 hyperintense, acetabulum, ishium and pubic bone. Concerned 30 minutes later
Thank you so much Dr. XXXXXXX I will most definitely get the biopsy done. Some of the benign conditions you mention make sense, most notably necrosis or inflammation. I currently have a small tear in my left hip labral but due to my profession as a basketball referee I haven't stayed off it and continue to run with the help of a couple of cortisone injections, pain medication and anti-inflammatories. After a game, my hip gets extremely inflamed. I would hope that this could be why I'm getting the abnormal MRI. It might be time to sit out for a while and get that tear healed.

My follow up question to you in regarding the wording of the "Impression" in the MRI findings. Why did the radiologist use the phasing "Differential diagnoses are led by... XXXXXXX before listing all the bad stuff and then say the less harmful diagnoses were less likely? Does that mean in his opinion it's most likely an infiltrating marrow disease such as leukemia or lymphoma or do they normally just list the most XXXXXXX diagnoses first?

Thanks again!
Answered by Dr. Pavan Kumar Gupta 7 hours later
As such there is no protocol to list harmful conditions first followed by harmless conditions.
It is just pure coincident,that your radiologist has listed harmful conditions first.
Above answer was peer-reviewed by
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