What is the diagnosis?
Prostate cancer metastases. Extensive sclerotic lesions such as these are almost certainly metastatic - the giveaway is the presence of metallic brachytherapy seeds, a not uncommon treatment for prostate cancer.
Extensive sclerotic bony metastases throughout the imaged skeleton. No fracture is identified.
Degenerative changes with loss of joint space and osteophyte formation affect both hip joints.
Metallic-density brachytherapy seeds projects over the expected position of the prostate.