Leukaemia infiltration LSBU

Description: Radiology case 448-341 Adult male with anaemia.
The particular feature is the low density of pubis and sacrum with relative sparing of ilia and femora. Patchy bone loss can be seen in both ischia and the proximal metaphyses of both femora, coarsening the visible bone architecture. There is a fairly well-defined area of patchy bone loss in the upper part of each pubic bone centred around the mid-line. Some cortical scalloping of the cortex of pubic bones is present. The density of the ilia is probably normal, except adjacent to the sacro-iliac joint margins where some more extensive destruction is seen on the right side. The density of Sacrum and vertebrae is reduced by what appears to be a patchy destructive process.
The appearance is of a patchy lytic bone process that is predominatly mid-line. This might suggest a process that affects active bone marrow, which is often restricted in the adult to the axial skeleton and the medulla of adjacent parts of long bones.