Bone lesion on X-ray but not MRI (??)

Thank, Kbeee for the feedback. This was an orthopedic surgeon who ordered the MRI w/o contrast. I think he was looking for rotator cuff, or some other shoulder issue. My oncologist sent me to him when the bone scan came back clear. He didn't order with contrast because he wasn't looking for tumor(s), even though he knew my history. I asked if a tumor would have shown up without the contrast just as well and he said yes. But then I wonder why MRI contrast is even used at all to evaluate bone tumors if that's the case?

I'm just at a loss now. Still a very steady and significant amount of pain, doesn't really go away or let up...fairly constant dull ache. Worse at night when I'm sleeping to the point of waking me at times. More advanced scans not showing anything, but basic xray shows a lesion. Weird! But doc doesn't think much of it in terms of being a tumor since other scans were negative. Of course, I just want a concrete answer of what it is/isn't because of my history and because I'm hurting and that lesion is the spot where it hurts! It's on my cancer side, on the humerus, and I'm not sure what to do next (if anything). Surely insurance isn't going to cover any further (different) scans. I wondered about a 2nd opinion with an orthopedic oncologist, taking him/her copies of my scans to see what they thought. The last time my oncologist brushed me off about chronic headaches I went on my own volition to see a neurologist because I was desperate and we learned I had a benign brain tumor. I'm just trying to find that balance of listening to my gut vs not being overly neurotic!

Did you have any treatment for your osteochondral lesion? Was it from an injury or just random? I had a cortisone injection today...ouch! Not sure how much it will end up helping, but I guess I appreciate the attempt at trying to alleviate the pain. I see him again in 4 weeks and he said we will repeat xray in 6 weeks and can repeat MRI in 3 months. I think I may ask for MRI with contrast next time around. I know there are risks from the dye related to the kidneys, I'll have to weight the risk vs benefit.

lekker, thank you for the feedback. I may do that after I follow up with the orthopedic doc in October. Where’s your bulging disc at? I’ve got one of those too in my lumbar spine and it can be a bear. I’m the oldest 37 year old I know! Lo

JoE777, I am sorry for your diagnosis. Thank you for sharing. What you described makes sense to me, that something wouldn’t show on X-ray but it did on MRI and then Pet, and that’s been typically what I’ve heard of...someone has pain that doesn’t show on scans, pain persists so different scans (more sensitive and specific) are ordered and then it shows up. My instance is opposite where something shows on the X-ray but the MRI report makes no mention of it. It’s confusing to me because it seems backwards.