the pt underwent a bone scan, which revealed irregular foci of tracer in lower t spine (t11-t12) consistent with compression fracture. there was also increased tracer in the posterior/lateral right ribs. on physical exam she was diffusely tender and in pain throughout her chest/ribs and spine. the pt also underwent chest ct, which demonstrated extensive parenchymal and pleural disease encasing the entire chest and involving vessels and bronchi. her adrenals and liver, vertebral bodies, and r scapula were also involved with metastatic disease.