71 years Female (DOB:5/30/1945)Reason: metastatic melanoma History: as abovePROVIDER/ATTENDING NAME: ANNE C CRAMER ANNE C CRAMER Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. The conus medullaris on sagittal imaging is grossly intact. There is an enhancing lesion within the L2 vertebral body and the right half of the L2 vertebra prior exam. There is a T1 hyperintense lesion present within the L3 vertebral body splays some contrast enhancement which could represent an atypical hemangioma but it given the other lesions could also represent hemorrhagic metastatic disease. It is unchanged compared to the prior exam. There is some ill-defined lesion in the right sacral alla associated with marrow replacement and contrast enhancement. There are multiple foci of marrow replacement in the left iliac bone. These were also present in the prior exam.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is moderate bilateral facet hypertrophy present at this level predominantly involving the left facet there is disc desiccation and loss of disc space height as well as a mild disc bulge at this level.At L4-5 there is loss of disc space height, disc desiccation and diffuse disc bulge associated with facet ligamentum flavum hypertrophy and overall a mild to moderate degree of spinal stenosis.At L3-4 there is loss of disc space height and disc desiccation and endplate reactive change associated with moderate facet and ligamentum flavum hypertrophy. Overall there is a mild degree of spinal stenosis at this level. There is a right far lateral disc protrusion at this level. There are Schmorl's nodes at this level.At L2-3 there is loss of disc space height, disc desiccation and diffuse disc bulge. There is mild bilateral facet hypertrophy and ligamentum flavum hypertrophy at this level. There is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina.There are endplate reactive changes present at T11-T12. No marrow replacing lesions are appreciated within the lumbar spine.There are multiple T2 hyperintense lesions scattered throughout the visualized portion of the liver.There is a cyst present in the left kidney measuring 10 mm in diameter.
1.Lesions in the lumbar spine, sacrum and iliac bones are suspicious for metastatic disease. These were also present on the prior exam.2.There are multilevel degenerative changes present in the lumbar spine with a mild to moderate degree of spondylostenosis at L4-5 and to a lesser degree L3-4.3.There multiple lesions present within the liver which are suspicious for metastatic disease.