Clinical question: Smoldering versus symptomatic symptomatic multiple myeloma, follow up on prior vertebral lesions. Signs and symptoms: No focal pain in these area. Pre-and enhanced cervical MRI:There is a well demarcated round mildly enhancing focus in the vertebral body of C6 measuring approximately 6 mm in size. The lesion demonstrate no appreciable change since prior exam in its signal intensity, size or pattern of enhancement.There is no evidence of an additional foci of marrow signal replacement or enhancement. This is a similar observations prior study. Moderate disk disease at C5 -- C6 and mild disk disease at other levels similar to prior exam. No spinal stenosis at any level. Degenerative changes however results in mild left neural foraminal compromise at C3-C4, mild bilateral neural foraminal compromise at C4 -- C5 and moderate right and mild left C5 -- C6 levels without significant change.There is normal signal intensity and caliber of cervical cord and without abnormal enhancement.Pre-and post-enhanced thoracic MRI:There is normal anatomical alignment of the vertebral column.There is normal signal intensity of which column.There is no detectable abnormal enhancement of vertebral column.There is no evidence of spinal canal or neural foraminal compromise at any level.There is normal signal intensity and caliber of cord and without evidence of enhancement.Pre-and post-enhanced lumbar MRI:Examination demonstrates an approximately 9 mm focus of T2 stir hyperintensity in the vertebral body of L1 with mild uniform enhancement without appreciable interval change since prior exam. There is no detectable additional foci of marrow signal change or abnormal enhancement of the vertebral column. This is a similar observations as the prior MRI exam.There is normal signal intensity and alignment the vertebral column.There is no evidence of spinal canal or neural foraminal compromise at any level.
1.MRI examination of cervical spine demonstrate stable 6-mm focus of marrow signal change and enhancement in C6 vertebral body without change since prior exam. No additional suspected lesions. No evidence of central spinal stenosis. Mild multilevel neural foraminal compromise as detailed per level. Normal signal intensity and caliber of cervical cord without abnormal enhancement.2.Pre-and post-enhanced MRI of thoracic spine is unremarkable and stable since prior study.3.Pre-and post-enhanced lumbar MRI demonstrates a single stable 8mm focus of marrow signal change with enhancement in the vertebral body of L1. Unremarkable and stable pre-and post enhanced lumbar MRI exam otherwise.