Smoldering multiple myeloma. Restaging. Sagittal alignment is anatomic. The vertebral bodies are preserved in height. Marrow is slightly heterogeneous though without suspicious focal lesion. T1/T2-hypointense lesion subjacent to the superior endplate of T11 has not changed since the previous examination and represent focal sclerosis, as evident on the CT part of the PET/CT scan dated March 29, 2016. There is desiccation and mild height loss involving L3-L4 and L4-L5 discs. There is focal contrast enhancement and T2-hyperintensity involving the right lateral aspect of the L3-L4 disc, probably representing annular fissure. The spinal canal is preserved. The conus medullaris tip is at upper L2 level. The conus medullaris has normal shape and signal. L4-L5 and L5-S1 facet arthropathy is moderate on the right at L4-L5 facet and mild elsewhere. There is mild right L4-L5 neural foraminal stenosis. The other neural foramina are fairly preserved. There is mild osteoarthritic change involving the sacroiliac joints, slightly more pronounced on the right.
1.The marrow is mildly heterogeneous but there is no destructive or definite marrow replacing lesion.2.Focal T2-hyperintensity and contrast enhancement in the L3-L4 disc annulus on the right probably represents annular fissuring.3.Degenerative disease in the lower lower lumbar spine otherwise.