81-year-old female with a history of a lung mass presents with back pain, concern for bony metastases; evaluate for spinal cord compression. This is a limited exam specific for the exclusion of cord compression only and does not exclude more subtle lesions such as intrinsic cord abnormalities or dural based metastases. There is diffuse patchy marrow replacement throughout the visualized spine.There are T2 hyperintense lesions corresponding to lytic lesions on recent chest CT and lumbar spine CT present. One is located on the right aspect of T5 and extends into the posterior elements of T5. There is soft tissue extension outside of the bony elements into the epidural space and into the adjacent T4-5 and T5-6 neural foramina. There is encroachment of exiting nerve roots at T4-5 and T5-6. There is no associated cord compression.There is a mild compression fracture present at T12 associated with a lytic lesion at T12 also visualized on the recent CT of the lumbar spine. There is no associated cord compression.There is a lytic lesion present along the anterior aspect of L2 which is hyperintense on T2 imaging and also identified on the recent CT of the lumbar spine. There is no associated cauda equina compressionThere are degenerative changes present in the cervical spine without evidence of associated spinal canal stenosis. This appears to be worse at C4-5, C5-6 and C6-7 where there are uncovertebral osteophytes and disc material narrowing neural foramina.There are degenerative changes present in the lumbar spine which appear worse at L5-S1 where there is a disc bulge present and loss of disc space heightA left lung mass lateral to the aorta and left-sided pleural thickening is partially imaged and better appreciated on the prior CT.
1.No evidence of spinal cord compression. Please note that this is a limited exam specific for the exclusion of cord compression only and does not exclude more subtle lesions such as intrinsic cord abnormalities, nerve root involvement or dural based metastases. 2.There is a lytic lesion present at T5 which extends into the surrounding tissues including the right neural foramina of T4-5 and T5-6 and the epidural space. There is encroachment of the right-sided exiting nerve roots at T5-6 as a result. There is no spinal cord compression appreciated.3.There is a lytic lesion present at T12 associated with a mild compression fracture which is been also identified in the recent lumbar spine CT. There is no associated cord compression.4.There is a lytic lesion present within the L2 vertebral body which was also identified on the recent lumbar spine CT.5.There is a left-sided long the mass present which is associated pleural-based lesion. Please refer to the recent chest CT for further comments.6.There are degenerative changes present in the cervical spine and lumbar spine without evidence of spinal cord compression or cauda equina compression.