Reason: 71yr old male with history of MM; pre-auto sct evaluation History: evaluate SKULL: There are a couple of small poorly defined lucencies within the calvarium, which were not clearly seen on the prior study and may reflect myelomatous deposits or venous lakes.CERVICAL SPINE: The bones appear diffusely demineralized but we see no focal myelomatous lesions. There is severe multilevel degenerative disc disease.THORACIC SPINE: The bones appear diffusely demineralized but we see no focal myelomatous lesions. The thoracic spine is kyphotic but there are no frank compression fractures. There is mild multilevel degenerative disc disease.LUMBAR SPINE: Degenerative disc disease affects the lower lumbar spine. There are no focal myelomatous lesions.RIBS: Small lucencies are noted within the left clavicle and a couple of the right ribs, which appear more prominent on the current study than on the prior study and are suspicious for myelomatous lesions.PELVIS: There is a lytic lesion of the right iliac wing, which appears similar to that seen on the prior study. Small lucency in the left pubic bone is slightly more prominent on the current study than on the prior study.UPPER EXTREMITY: There are a few small lucencies in the proximal left humeral diaphysis, which may represent small myelomatous lesions but appear similar to those seen on the prior study. Small lucency in the left proximal radial diaphysis may also represent a small myelomatous deposit but appears similar to the prior study. Mild osteoarthritis affects the right shoulder. No definite myelomatous lesions are seen in the right upper extremity.LOWER EXTREMITY: We see no discrete myelomatous lesions in the bilateral femurs although numerous lesions are seen on the recent MRI exam. Calcifications adjacent to the right greater trochanter appear similar to prior. Poorly defined lucency in the proximal right tibial metaphysis may represent a myelomatous deposit but is unchanged from the prior study.
Multiple myeloma as described above. A few small lesions appear slightly more prominent on the current study than on the prior study. While this may be simply due to differences in technique, we cannot exclude the possibility of disease progression.