Reason: History of multiple myeloma, lower back and bilateral hip pain, r/o lesions History: bilateral hip and lower back pain 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. No abnormal enhancing lesions are appreciated in the lumbar spine.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is loss of disk space height, disk desiccation and a disk bulge present at this level. There is mild facet and ligamentum flavum hypertrophy present at this level. Overall this is not changed substantially compared to the previous examAt L4-5 there is bilateral facet and ligamentum flavum hypertrophy present associated with a disk bulge, loss of disk space height and some partial effacement of the fat at the lateral recess is compared overall there is a moderate degree of spinal stenosis present at this level. There is redemonstration of ill define contrast enhancement and increased signal on T2 STIR images adjacent to the facet joints and ligamentum flavum at this level which is suspected to be inflammatory in origin.At L3-4 there is no significant compromise to spinal canal or neural foramina. There is a bulge present at this level associated with ligamentum flavum hypertrophy.At L2-3 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 is disk desiccation and a disk bulge at this level.Incidental note is made of fatty filum terminally.There is a 15-mm well-circumscribed the lesion present along the right posterior lateral aspect of the L1 vertebral body which is bright signal on T1 appear to be stable compared to the prior exam and most likely represents hemangioma.A small cyst is present in the right kidney which is stable since the prior exam.
1.There is redemonstration of degenerative changes in the lumbar spine which are stable compared to the previous exam. This is worst at L4-5 where there is a moderate degree of spinal stenosis present .2.There is no MRI evidence for multiple myeloma involvement of the lumbar spine.