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L1 vertebral hemangioma

I had an MRI of the right hip and lumbar spine, which incidentally showed a "L1 benign-appearing hemangioma within the background of fatty marrow replacement, suggesting osteopenia."  How are these caused?  I fell at the end of a short hike  in Sept 2007 landing hard on my buttocks/low back with pain lasting about a month, sought no medical care.

I am a medical transcriptionist, have been for 38 years, I have never transcribed about this in my life.  I have absolutely no symptoms of any kind other than the occasional low back pain from over use from time to time. This MRI also revealed slight spinal stenosis, multilevel foraminal narrowing.  I had a DEXA scan 2 years ago and at age 56 I was diagnosed with the bones of a 30 year old. Now all of a sudden I have osteopenia?  I know that's not full blown osteoporosis, but still.  Is this hemangioma something that I can leave alone as long as I am asymptomatic? I am now 58, am active with walking and bicycling and dancing.  This MRI also revealed  hip space narrowing, low-grade, partial-thickness articular-sided tear of the right gluteus medius tendon, which hopefully will heal with TLC and whose pain waxes and wanes.

I do have appt with PCP to talk about all of this and have made an appt with an orthopedic surgeon who specializes in hips, but now am wondering if I should perhaps seek the advice of one who specializes in spine.  My grandmother had arthritis of her spine, but I do not know the particulars, she was stooped in walking.

Any thoughts are appreciated.
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