An x-ray from 2011 found bone lesions in my right femur. Here is the text from the report:
Findings: There are at least 2 intramedullary radiolucent lesion of the distal femoral diaphysis, measuring 1.4 x 0.9 cm and 2.8 x 1.0 cm. These lesions show mild peripheral sclerotic changes without appreciable cortical erosion or soft tissue components. A Lowell the radiographic characteristics are nonaggressive, further characterization may be needed a followup MRI of the right side, if clinically indicated. The exam otherwise demonstrates no evidence of fractures, dislocations or other abnormalities involving the bony architecture.
I had another x-ray last week. Here is the text from that report:
No acute fracture or dislocation. Lobulated lucent lesion at the distal femoral diaphysis measures approximately 6 cm craniocaudally, with somewhat circumscribed narrow zone of transition superiorly with indistinct margins inferiorly and laterally. No periosteal reaction. Again, the appearance is most suggestive of a nonaggressive lesion with an ossifying fibroxanthoma felt to be the most likely consideration. Followup radiograph in 12 months is suggested to document further stability.
My questions are:
1.) Is it possible for a radiologist to mistaken multiple lesions as one large lesion, or vice versa? As in, could one of these reports potentially have been wrong because the measurements could have been done inaccurately?
2.) If the first report says the lesion(s) has "mild peripheral sclerotic changes" and the second report says "somewhat circumscribed narrow zone of transition superiorly with indistinct margins inferiorly and laterally," does that mean the lesion(s) has changed...or could these mean the same thing?
3.) What is the general interpretation of the latest finding? Is this something that should be further investigated, or does this sound like the lesion(s) is stable?
I met with a medical oncologist today, who said she felt she needed to consult with radiology to further confirm the findings between the two x-rays. In the meantime, I wanted to see if I could get any information regarding what these results could mean. If the radiologist could potentially have made a mistake where this could be deemed nonaggressive but there are signs of concern that would encourage further investigation or testing, I'd like to know to get a second opinion.
I understand your concern regarding the xray result. Radiologist's interpretation of xray result are usually objective and what is actually seen in the xray plate. However, it is possible that the findings have changed considering that the time difference is 2 years from the initial xray. I agree with your attending physician's decision to consult with radiology to confirm the result of the two xray first prior to further evaluation. Take care and do keep us posted.
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