Smoldering myeloma patient screening for clinical trial. Evaluate for myeloma lesions. The patient initially presented for her MRI examination on January 13, 2015. The examination was incomplete, and therefore the patient returned for additional imaging on January 16, 2015 (accession # 14675404). The following dictation represents an interpretation of both examinations combined.There is diffuse intermediate signal intensity within the medullary space of the lumbar and visualized lower thoracic vertebrae, as well as more patchy intermediate signal intensity within the medullary space of the bones of the pelvis. This could simply reflect residual red marrow; however, I cannot exclude the possibility of a myeloproliferative process such as multiple myeloma. There is a subcentimeter focus of increased signal intensity relative to suspected red marrow on the fat-suppressed T2-weighted images within the body of the right pubic bone adjacent to the pubic symphysis. This lesion is of low signal intensity on T1-weighted images relative to suspected red marrow, and shows enhancement following contrast administration greater than that of suspected red marrow. While nonspecific, this is compatible with a small myelomatous lesion. A degenerative subchondral abnormality is considered less likely given the relatively normal appearance of the pubic symphysis itself. Poorly defined signal abnormality and enhancement within the posterior aspect of the left iliac wing is favored to represent postbiopsy change rather than myelomatous involvement. There is a lobulated focus of near-fluid signal intensity seen within the fifth sacral segment on the fat-suppressed T2-weighted images. It is of intermediate signal intensity on T1-weighted images and does not appear to enhance. It may represent a small cyst or benign cartilage rest, but I suspect does not represent a myelomatous deposit. Moderate osteoarthritis affects both hip joints with small foci of signal abnormality the subchondral bone that is likely degenerative in etiology. Degenerative arthritic changes of the lower lumbar spine are noted; please refer to the accompanying spine MRI report for further information. The musculature of the pelvis appears normal. While the study was not protocoled for detailed evaluation of the abdominal and pelvic viscera, I see no abnormalities.
1.Subcentimeter round focus of signal abnormality and enhancement within the body of the right pubic bone. While nonspecific, this compatible with a myelomatous lesion.2.Diffuse/patchy intermediate signal intensity within the medullary space of the visualized spine and pelvic bones may simply represent red marrow, although I cannot exclude the possibility of a myeloproliferative disorder such as myeloma.3.Other findings as above.