Male, 68 years old, with multiple myeloma. Evaluate for new myelomatous lesions. Grade 1 anterolisthesis of L4 relative to L5 is unchanged. Spinal alignment is otherwise anatomic. Vertebral body height and morphology are within normal limits. Mild degenerative endplate edema is seen at C5-6, slightly progressed from prior. Scattered focal fatty lesions within the thoracic spine may represent hemangiomas and are unchanged. Heterogeneous mildly enhancing, STIR hyperintense marrow signal within the sacrum and iliac wings is probably unchanged when compared to the prior MRI. The pattern of this abnormality is symmetric bilaterally. Of note, there is no corresponding hypermetabolism on a recent PET/CT and no abnormalities on the CT portion of the exam.Marrow signal is diffusely low on T1 and T2-weighted images compatible with marrow reconversion, similar to the prior exam. No evidence of pathologic marrow replacement or any focal marrow lesion is seen.The visualized spinal cord shows normal signal intensity throughout. No pathologic parenchymal or leptomeningeal enhancement is identified.C2-3: Left facet hypertrophy. Minimal posterior disc-osteophyte complex formation. No spinal canal stenosis. Mild left foraminal narrowing. C3-4: Bilateral facet hypertrophy. Minimal posterior disc-osteophyte complex formation. No spinal canal stenosis. Moderate left foraminal narrowing. C4-5: Bilateral facet hypertrophy right greater than left. Posterior disc-osteophyte complex formation asymmetric to the right. Mild generalized spinal canal stenosis particularly affecting the right lateral aspect of the spinal canal. Moderate to severe right foraminal narrowing. C5-6: Bilateral facet hypertrophy. Posterior disc-osteophyte complex formation. Moderate generalized spinal canal stenosis. Moderate left foraminal narrowing. C6-7: Facet hypertrophy. Minimal posterior disc-osteophyte complex formation. No spinal canal stenosis. Mild left foraminal narrowing. C7-T1: Unremarkable. In the thoracic spine, scattered small disc protrusions are seen most notably at T11-12 without significant interval change. No spinal canal or foraminal stenosis is observed.L1-2: Facet arthropathy and ligamentum flavum thickening. Mild disc bulging. Minimal spinal canal stenosis and mild bilateral foraminal narrowing. L2-3: Facet arthropathy and ligamentum flavum thickening. Mild disc bulging. Mild spinal canal narrowing. Moderate bilateral foraminal narrowing. L3-4: Facet arthropathy and ligamentum flavum thickening. No significant spinal canal stenosis. Mild bilateral foraminal narrowing. L4-5: Marked facet arthropathy, worsened on the right with evidence of surrounding inflammation. Disc uncovering and disc bulging. Mild spinal canal narrowing. Moderate to severe left and moderate right foraminal narrowing. L5-S1: Marked facet arthropathy. No significant spinal canal or foraminal stenosis. Multiple bilateral renal cystic lesions are partially visualized.
1.No evidence of any discrete myelomatous lesions in the spine.2.Diffuse marrow reconversion appears similar to prior.3.Bilateral symmetric ill-defined signal abnormality and enhancement within the sacral ala and iliac wings is most likely benign and may represent subacute to chronic bone infarction.4.Scattered relatively mild degenerative findings are redemonstrated as above. Facet arthropathy has progressed on the right at L4-5.