Male 55 years old Reason: History of multiple myeloma, evaluate disease History: diffuse joint pain SKULL: No significant abnormality notedCERVICAL SPINE: Severe degenerative changes affects the mid to lower cervical spine which large arterial osteophytes and disc space narrowing.Carotid calcifications are present.No evident lucent lesions.THORACIC SPINE: The bones are demineralized. There is multilevel degenerative disc disease and anterior osteophytes.There are multiple rib fractures.LUMBAR SPINE: Degenerative changes affects the lower lumbar spine predominantly at L4-L5 anterior disc osteophytes.RIBS: There are multiple rib fractures with healing.PELVIS: Multiple lucent lesions are noted in the ischium bilaterally. No acute fracture or malalignment.UPPER EXTREMITY: Large expansile lesion involving the right scapula. Lesions also involve the right clavicle and acromion. The avascular necrosis of the right humeral head is better evaluated by MRI.There are several scalloped lucencies involving the right proximal humerus compatible with myelomatous deposits.Subtle lucency in the right distal radius aspect suspicious for myelomatous lesion.Degenerative changes affects the left acromioclavicular joint. There are several well marginated lucencies involving the left proximal humerus compatible with myelomatous deposits. No evident myelomatous deposit in the left forearm.LOWER EXTREMITY: Multiple well-defined lucencies involving the right proximal femur compatible with myeloma.Sclerotic lesion involving the metaphysis of the right proximal tibia may represent an enchondroma. There are few scattered lucencies involving the left proximal femur.
Multiple myeloma with lesions involving the humerus femurs pelvis as detailed above