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Done with MRI of pelvis. What are the findings from the report? Is there any abnormality?

Apr 2014
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Practicing since : 2004
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My daughter recently had an MRI of her pelvis due to tenderness in the right ischium. She is an 11 year old gymnast. Below are excerpts from the radiologist report. What does it all mean? Does she have a stress fracture?
Findings: There is a focal area of mild expansion and signal abnormality in the inferior ramus of the right pubic bone, as visualized on the coronal images 10 and axial images 25-26. The medullary bone at this 1cm in diameter focus is hyperintense on T2 weighted sequences and undergoes prominent contrast enhancement. There is subtle marrow hypeintensity on fat suppressed T2 weighted sequences in the adjacent aspects of the pubic bone and ischium. There is minimum edema in the adductor immediately adjacent to the lateral surface of the abnormal segment of right pubic bone. The other soft tissues in the field of view are normal. There is no extraosseous soft tissue mass.

Impression:The findings of marrow edema in the inferior ramus of the right pubic bone and ischium are most compatible with repetitive stress. There is only minimal edema in the adjacent soft tissues. The focal area of bone expansion and signal abnormality is most likely due to delayed closure and stress changes at the ischiopubic synchondrosis.
Posted Sat, 7 Sep 2013 in X-ray, Lab tests and Scans
Answered by Dr. Indu Kumar 1 hour later
Brief Answer:

Yes, she is suffering from stress fracture.

Detailed Answer:

Hello XXXX,

Findings of MRI Scan is in favour of stress fracture involving Right Pubic bone and Ischium.
Stress fracture is commonly seen in athletes and it results from excessive use.
Stress fracture is considered as exaggerated bone remodeling response in response to repetitive submaximal stresses.
Stress fracture has wide range of MRI findings ranging from periosteal edema to marrow edema to true cortical fracture.
Accurate grading is important for clinical management of these patients.

MRI of your daughter shows
1.Inferior ramus of right pubic bone at ischiopubic joint shows 1 cm size lesion which is hyper intense on T2 weighted images and it shows strong contrast enhancement. Lesion is most likely due to delayed closure and stress changes.
2.There is also bone marrow edema in inferior ramus of right ischiopubic bone and it is also likely due to repetitive stress.
3.There is also minimal edema in adjacent adductor muscle.
4.Other soft tissues in field of view is normal.
5.There is also no soft tissue mass outside the bone.

Get well soon.
Hope you have understand the terms.
Further queries are most welcome.
Take Care
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