how bad is this??

Indication: Right lower rib pain and upper right lumbar pain. Lytic lesions on recent MRI pelvis. 

Findings: Images are degraded by patient movement. There are well-defined T1 and T2 hypointense osseous metastases in multiple cervical, thoracic, lumbar and sacr al vertebral bodies, pelvis and bilateral ribs. No involvement of the posterior spinal elements, pathological fracture, soft tissue encroachment into the spinal canal or neural foramina demonstrated. There is mild cervical and thoracic spondylosis. There is mild bilateral neural foraminal narrowing in the lumbar spine due to disc and facet joint degenerative changes. There is a large right pleural effusion, 

Impression: Osseous metastatic disease throughout the spinal vertebral bodies, sacrum, pelvis and ribs. No neural compression. Large right pleural effusion suggesting possible lung primary. Urgent CT thorax, abdomen and pelvis is recommended.