Lack of fatty marrow, should I be worried?

Patient: I recently had an MRI done for lower back pain. The results came back noting a couple of bulging disks and the following: “Near complete absence of fatty marrow throughout the visualized spine, which is atypical in this age patient. Although this can be normal in patients with increased oxygen requirements (such as athletes and those living at high altitudes) it can also be seen in cases of severe chronic anemia or neoplastic marrow-replacement. Suggest clinical and laboratory correlation.” I had an MRI done about a year ago and there was no mention of a lack of fatty marrow then. Additionally, I had a complete work up done about a year ago and no anemia was found. Is this something I should be worried about?

Doctor: The way of reporting results of MRI may be different for each MRI place, so the question is, did you do both MRIs in the same place?, are you an athlete or live in high altitudes?, do you have history of chronic anemia ?, if the answer is No to these questions and you have those findings, I strongly recommend a further evaluation by a specialist, that helps you to clarify the situation.