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Osteoporosis and CT scan results

User
Posted 29 Jan 2024 at 06:21

I have a query if an osteoporotic spine and osteopenia in hips and femur found after a DEXA bone mineral scan (June 2023) could be interpreted on a CT scan (Dec 2023) as cancerous spots in the bones.  OH recently had an additional CT scan after referral back to Urology to check up on a renal cell carcinoma found during PCa diagnosis, which luckily has not grown in a year so we can leave alone for now, but the consultant mentioned that the CT scan showed up what could be cancerous spots in the spine and pelvis and encouraged OH to continue taking HT.  I am probably overthinking things but hoping the effects of osteoporosis in the spine could be showing up as changes to the bone structure in the CT scan and doesn’t mean PCa has now spread to bones.  OH’s original bone scan Nov 2022 was clear.  We must wait until Jun 2024 for our next meeting with the Oncologist before we can talk about this.  OH diagnosed G4+5, T3b N1 M0 PSA 290 now down to PSA 2.3 after having HT (since Nov 2022) and RT (May 2023), OH declined chemo so on a sub-optimal treatment plan from the consultant’s perspective. 

User
Posted 29 Jan 2024 at 10:22

I would ask for an urgent referral to orthopedics to get the scans checked there and see if they think it's osteoporosis or mets. They are probably more familiar with what osteoporosis looks like, although equally, the radiologist who analysed the scans may have that experience.

However, diagnostic procedures are usually only performed when clinically significant, i.e. when they might change treatments. If he's refusing treatments, then diagnostic procedures which might normally be clinically significant become less so, and are less likely to be offered, as their results are not going to be acted upon.

 
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