I had a CT scan for pelvic pain. What does the film indicate?

Hi,

Welcome to icliniq.com.

Thanks for writing into us and I have gone through the CT scan images (attachment removed to protect patient identity).

There is a lesion in the right intertrochanteric area and is showing characteristics of an osteoma and is almost always a benign condition. One must look out for any severe pain and any abnormal bone growth in the area. Many osteomas might disappear with time and no active treatment is needed. In cases when the pain is severe then surgery and bone curettage might help.

There is a likely area of excess calcium deposition and showing a white spot in the left iliac bone near the left sacroiliac joint area and is called a bone island. A bone island is usually not treated. However to confirm a bone island and to rule out other lesions, a nuclear bone scan can help.

The thickening of the left anterior pararenal fascia is likely not significant.

The gall bladder is not well visualized.

Hi,

Welcome back to icliniq.com.

Thanks for writing into us.

By definition, an osteoma is usually smaller than 2 cm in size. In your case, the lesion in the intertrochanteric area of the right femur is 15 mm and can appropriately fit into the definition of an osteoma. Osteoid osteomas are more common in a younger age group from 10 to 35 years. A central sclerotic dot is seen in many lesions, but not in all lesions.

However, the other differentials can include LSMFT keeping in mind the location and lucent center with sclerotic margins and being mildly expansile and is slightly more common in males at age 30 to 40 years.

Both conditions can cause vague pain and discomfort in the area of the lesion.

Treatment options in both cases are confirmation by biopsy and surveillance. Surgery is a though only in cases of suspected aggressive activity in the lesion.

In view of the size and the lesion being minimally expansile and a smaller lucent component, I would prefer to go for an osteoid osteoma as the first diagnosis and keep LSMFT as the second diagnosis.

Other less likely differentials for this condition might include, fibrous dysplasia, non-ossifying fibroma, polymorphic fibro-osseous tumor of bone, myxofibroma, lipoma, cyst, bone infarct, Paget's disease, and chondroma.