My husband age 61 just had an MRI of his sacrum and lumbar spine. Both areas showed heterogenous marrow signal with scattered T 1 hypo intense foci. He has had low back and hip pain for 1 year off and on. Now after 6 months of chiropractic treatment and 2 SI joint steroid injections by a pain management Dr. For what we thought was simple sciatica, he is no better. His only other co-morbidities are HTN, high iron in his liiver and arthritis with already having bi-lateral TKRs. No known renal problems or anemia and he doesn t smoke. Can you possibly tell us which direction to go?
Hi, In my opinion, you should get done repeat MRI of the lower spine.  If marrow heterogeneity is increased and or hypoechoic loci is increased in size then the possibility of malignancy is more likely. So consult the orthopedic doctor and get done repeat MRI. He may also need PET scan to rule out possible cancer.  Hope I have answered your query. Let me know if I can assist you further.