MRI Findings confusing

I received a MRI for some pain I had in my hip as I had a prior bone met that was taken care of with radiation. However due to recent pain my doctor wanted to scan this area again. I have ovarian MMMT. Could you please translate what this MRI says:

-Situated on the inferior sacrum on the left, abutting the SI joint, there is a focal area of low t1 signal isointense to skeletal muscle. This area demonstrates heterogeneous intermidate to high signa on T2 imaging, and is relatively intense on the STIR images. On the SPIR images this lesion enhances in a slightly heterogeneous fashion. On MRI images the cortex does not appear to be broken down, however , I have retroactively reviewed the CT study, and the cortex does appear to be broken in this area. My main concer would be a destructive lesion, and metastatic disease would be a primary consideration although to my knowledge it would be very rare for an ovarian primary neoplasm to involve bone without more extensive peritoneal and diffues soft tissue involvement. It is possible that this finding could represent infection, however, I would expect osteomyelitis to be clinically apparent.

-Also, I am currently on ifos/cis have you ever seem chemo clear up a bone met?

Thank you for your time

[Annekathryn Goodman, M.D.]

Hi there,
i suspect that if this MRI finding is where you previously received radiation, then what the MRI is seeing is a treated metastases.
i would suggest 2 things:

-a consultation with an orthopedic doctor to go over your films with you
- a bone scan

when we have uncertainty about a lesion in the bone, a biopsy is sometimes considered.

As an aside, if you have had radiation to your bone, you are at risk fora fracture. you should ask your doctor about starting a medication such as actonel, xometa, or fosamax to strengthen your bones and reduce the risk of fracture

best wishes