Reason: back pain History: metastatic breast cancer Again noted is abnormal marrow signal involving T4, T6, T7 vertebral bodies with associated enhancement and now slightly ill-defined margins. Disease again extends into the right T4 pedicle, transverse process, and and pars interarticularis, with subtle progression of the anterior and posterior extent of abnormal signal although portions of the are now predominantly low signal compatible with sclerosis. Additional posterior element involvement is seen at T6 and T7 on the right. There is also minimal involvement on the left at T6 and T7. Findings appear very minimally progressed at all these levels. In addition, there is emerging abnormal enhancement involving the majority of the T2 vertebral body as well as the upper T3 vertebral body although there is no definite abnormal signal at this time.The thoracic spine is in normal alignment, with a normal thoracic kyphosis. The vertebral body and disk heights are stable. The spinal cord is of normal caliber and signal.There is redemonstration of mild to moderate left T5-T6 and T6-T7 narrowing secondary to facet arthropathy. There is no significant central spinal canal stenosis at any level.There is partial visualization of bilateral breast implants. There is presumed pleural parenchymal scarring at the right lung apex. There is a prominent T2 hyperintense oval lesion within the left lobe of the thyroid gland with enlargement of the left lobe of the finding measures up to 1.6 cm. There are trace right greater than left pleural effusions.
1. Slight further progression of scattered osseous metastatic disease along the upper to midthoracic spine, with additional areas of abnormal emergent enhancement identified in T2 and T3 vertebra. No acute compression deformities appreciated.2. Stable mild to moderate left foraminal narrowing at T5-T6 and T6-T7 on the left secondary to facet arthropathy.