Findings:
Multiple, small STIR hyperattenuating lesions are seen involving the sacrum and extending to sacral alae bilaterally. Diffuse signal abnormality is also seen in bilateral iliac bones. No fracture line could be identified.
Further, small foci of T1 and T2 hypointensity are seen throughout the spine, suggestive of pathological process of marrow infiltration and replacement.
A rounded T2/STIR hyperintense lesion is seen in T11 vertebral body, likely in keeping with a vertebral haemangioma.
The craniocervical junction is normal. The cord and conus are unremarkable, as is the cauda equina. The cord terminates at T12.
There are multiple large flowing osteophytes anteriorly between C4 and T1, consistent with diffuse idiopathic skeletal hyperostosis (DISH). Modic-1 endplate changes are seen at C6/7.
Multilevel disc protrusion and bilateral osteoarthritis of the uncovertebral joints and facet joints is seen at C3/4 – C6/7 with high-grade neural exit foraminal stenosis at C3/4 and C4/5 on the right as well as at C5/6 and C6/7 bilaterally.
Anterior osteophytes are seen in the thoracolumbar spine.
Mild disc bulging is seen in the lumbar spine without any relevant stenosis.
Soft tissue thickening with oedematous changes is seen in the presacral region.
Conclusion:
Bony metastases involving the sacrum and the iliac bones bilaterally without evidence of pathological fracture.
Also, further smaller lesions and possible diffuse marrow infiltration and replacement are seen throughout the spine.
Degenerative multilevel neuroforaminal stenosis in cervical spine at C3/4 – C6/7. No central canal stenosis, no cord compression or myelopathy.