Presentation
Known hematologic disorder, severe lumbar spine, and pelvic pain – possible bony pathology.
Patient Data
No previous imaging available for comparison.
Grade 1 anterolisthesis of L3/L4, with suspicion of a pars defect at L3.
Diffuse background sclerosis and coarsened trabecular pattern, in keeping with known myelofibrosis.
Multilevel degenerative disc disease and facet joint degeneration.
Sacralization of L5.
No significant degenerative changes at the hips.
The spleen is markedly enlarged, measuring 20 cm in bipolar length, indicative of splenomegaly.
Case Discussion
Essential thrombocythemia progressed to myelofibrosis.
Bone marrow biopsy was performed. Trephine features consistent with progression to myelofibrosis (abnormal megakaryocytes, increased reticulin).
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