Female, 71 years old, with history of multiple myeloma status post stem cell transplant presenting with diffuse weakness. Evaluate for new spinal lesions. Cervical:Grade 1 retrolisthesis of C3 relative to C4 is unchanged. Vertebral body height and morphology are within normal limits. No concerning marrow replacement is seen. No pathologic marrow enhancement is evident.The spinal cord demonstrates normal signal intensity throughout. No abnormal intramedullary or leptomeningeal enhancement is seen. No epidural abnormalities are suspected.C2-3: No spinal canal stenosis or neuroforaminal narrowing. C3-4: Posterior disc-osteophyte complex formation. Moderate spinal canal stenosis with slight flattening of the ventral cord. Moderate left foraminal narrowing. No interval changes.C4-5: Posterior disc-osteophyte complex formation. Mild spinal canal narrowing. No significant foraminal narrowing. No interval changes.C5-6: No spinal canal stenosis or neuroforaminal narrowing. C6-7: Posterior disc-osteophyte complex formation. Mild spinal canal stenosis. No significant foraminal stenosis. No interval changes.C7-T1: No spinal canal stenosis or neuroforaminal narrowing. Thoracic:Alignment is anatomic. Vertebral body heights are preserved. T1 isointense and T2 hyperintense signal within the left T3 vertebral body is unchanged and probably represents an atypical hemangioma.The spinal cord demonstrates normal signal intensity throughout. No pathologic intramedullary or leptomeningeal enhancement is seen. No epidural abnormalities are suspected.Scattered facet arthropathy and minimal disc degeneration is seen through the thoracic spine. No areas of high-grade spinal canal or foraminal stenosis are detected.An enhancing mass in the right retrocrural space at T12 is unchanged in size measuring up to 28 x 11 mm in the axial plane. Small T2 hyperintense lesions are demonstrated in the liver, likely cysts.Lumbar:A transitional L5 vertebral body is seen. Vertebral body morphology is otherwise unremarkable. Marrow signal is somewhat heterogeneous but there are no suspicious areas of marrow replacement or enhancement. Endplate degeneration with associated marrow signal changes seen at L3-4. Mild edema and enhancement in the left iliac crest is seen, potentially related to recent bone marrow biopsy.The distal spinal cord, conus and cauda equina are unremarkable except as discussed below. No epidural abnormalities are suspected. No leptomeningeal enhancement is seen.L1-2: Facet arthropathy. Minimal disc bulging. Mild generalized spinal canal stenosis with slight crowding of the cauda equina. No significant foraminal narrowing. No interval changes. L2-3: Facet arthropathy. Mild disc bulging. Moderate generalized spinal canal stenosis with crowding of the cauda equina. Mild bilateral foraminal narrowing. No interval changes. L3-4: Facet arthropathy. Minimal bulging disc. Moderate generalized spinal canal stenosis with crowding of the cauda equina. Moderate bilateral foraminal narrowing. No interval changes. L4-5: Facet arthropathy. Minimal bulging disc. No significant spinal canal stenosis. Moderate left and mild right foraminal narrowing. No interval changes. L5-S1: A conjoined L5-S1 nerve root is seen on the left. No significant spinal canal stenosis or neuroforaminal narrowing.
1.No clear evidence of osseous myelomatous disease.2.Stable mass in the right retrocrural space at T12.3.Degenerative findings are redemonstrated without significant interval change.