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Diagnosis: The x-ray shows a lesion over the right ilium, as marked by the arrows. Initially, this was thought to be overlying gas.
However, closer attention reveals that the bone abutting the lesion is slightly thickened.
In addition, the edge of the lesion ends at the lower border of the ilium (whereas a gas bubble would have a separate border, distinct from that of the bone).
The radiologist’s opinion was that this was an osteolytic lesion that required CT for further follow-up.
The fact that this was a random finding teaches a valuable lesson: Do a complete, thorough reading of all films, regardless of the focused complaint.
Case presented by Nahum Kovalski, BSc, MDCM.
[taq_review]
55-year-old female experienced blow to back from fall
Nahum Kovalski, BSc, MDCM
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