 Images are limited by patient motion. The cervical spine is in normal alignment, with straightening of the normal cervical lordosis. There is mild disc narrowing at C5-C6. The vertebral body and disk heights are otherwise well-maintained. There are scattered areas of abnormal marrow signal and mild enhancement within the cervical vertebrae along the posterior superior C7 vertebral body. Spinal cord is of normal caliber and signal. At C2-C3, there is a shallow central disc protrusion and mild left facet arthropathy.At C3-C4, there is a stable mild posterior osteophyte disk complex with tiny central annular fissures. There is mild bilateral uncovertebral hypertrophy resulting in mild bilateral foraminal narrowing. There is overall mild to moderate central spinal canal stenosis as there is also minimal ligamentum flavum thickening. Flattening the ventral cord is noted.At C4-C5, there is a stable tiny central disc protrusion indenting the ventral thecal sac with no significant stenosis.At C5-C6, there is a stable mild diffuse posterior osteophyte disk complex with slight left sided prominence. There is left greater than right uncovertebral hypertrophy, facet arthropathy, as well as ligamentum flavum thickening. There is moderate central spinal canal stenosis as well as moderate left and mild to moderate right foraminal narrowing.At C6-C7, there is progression of previous pathology, with persistent posterior osteophyte disk complex with superimposed central/right paracentral disc protrusion indenting the ventral cord. There is There is mild bilateral uncovertebral hypertrophy as well as facet arthropathy and ligamentum flavum thickening. There is mild to moderate central spinal canal stenosis and mild bilateral foraminal narrowing.At C7-T1, there is no significant disk pathology or stenosis. Small nerve root sleeve cysts are incidentally noted at this level.The previously seen rounded T2 hyperintense lesion within the left thyroid gland now measures 3 x 3 mm, having decreased in size from previous 7 x 6 mm. There is prominent patchy STIR hyperintensity throughout the pons which is nonspecific but may relate to small vessel ischemic changes.THORACIC SPINE
1.Diffuse osseous metastatic disease throughout the spine, with moderate pathologic compression deformity of T6 and mild-moderate compression deformity of T11, with only minimal retropulsion of fracture fragments although there is associated up to moderate right T6-T7 foraminal narrowing. Diffuse involvement of L3 vertebral body with only mild concavity of the endplates.2.No significant epidural disease at any level this time, and no evidence of pathological intrathecal enhancement.3.Pleural based enhancing mass along the right lower lobe with adjacent destructive metastatic lesion involving the right T6 posterior rib. Additional metastatic lesions in the manubrium and right clavicular head.4.Focal abnormality along the left lateral aspect of the aortic arch is suspected to represent focal aortic saccular type aneurysm which may be ulcerative, as this does not appear to have an appearance of adjacent periaortic node. CTA of the chest would be helpful for further evaluation. Other areas of scattered mural thickening are noted consistent with atherosclerotic disease.5.Right adrenal mass concerning for metastatic disease. Severely atrophic right kidney.6.Transitional lumbosacral anatomy as detailed above. If surgery is to be contemplated, correlation with imaging of entire spine is recommended.7.Scattered spondylotic changes throughout the spine, with high-grade foraminal narrowing along the lower lumbar spine. Please see above for details.