Female, 71 years old, history of multiple myeloma, status post stem cell transplant with worsening back and leg pain. Outside hospital imaging in November 2015 showed lesions at T12 with no compression. Cervical:Grade 1 retrolisthesis of C3 relative to C4 is seen. Vertebral body height and morphology are within normal limits. No concerning marrow replacement is seen. No pathologic marrow enhancement is evident.The spinal cord demonstrates normal signal intensity throughout. No abnormal intramedullary or leptomeningeal enhancement is seen. No epidural abnormalities are suspected.C2-3: No spinal canal stenosis or neuroforaminal narrowing. C3-4: Posterior disc-osteophyte complex formation. Moderate spinal canal stenosis with slight flattening of the ventral cord. Moderate left foraminal narrowing. No interval changes.C4-5: Posterior disc-osteophyte complex formation. Mild spinal canal narrowing. No significant foraminal narrowing. No interval changes.C5-6: No spinal canal stenosis or neuroforaminal narrowing. C6-7: Posterior disc-osteophyte complex formation. Mild spinal canal stenosis. Mild right foraminal narrowing. No interval changes.C7-T1: No spinal canal stenosis or neuroforaminal narrowing.  Thoracic:Alignment is anatomic. Vertebral body heights are preserved. T1 isointense and T2 hyperintense signal within the left T3 vertebral body is unchanged and probably represents an atypical hemangioma.The spinal cord demonstrates normal signal intensity throughout. No pathologic intramedullary or leptomeningeal enhancement is seen. No epidural abnormalities are suspected.Scattered facet arthropathy and minimal disc degeneration is seen through the thoracic spine. No areas of high-grade spinal canal or foraminal stenosis are detected.An enhancing nodule in the right retrocrural space at T12 measures up to 28 x 11 mm in the axial plane. The lesion is relatively dark on T2-weighted images which would suggest chronic blood products, mineralization or a fibrous component. There has been no significant interval change.Lumbar:A transitional L5 vertebral body is seen. Vertebral body morphology is otherwise unremarkable. Marrow signal is generally somewhat heterogeneous but there are no suspicious areas of marrow replacement or enhancement.The distal spinal cord, conus and cauda equina are unremarkable except as discussed below. No epidural abnormalities are suspected. No leptomeningeal enhancement is seen.L1-2: Facet arthropathy. Minimal disc bulging. Mild generalized spinal canal stenosis with slight crowding of the cauda equina. No significant foraminal narrowing. No interval changes. L2-3: Facet arthropathy. Mild disc bulging. Moderate generalized spinal canal stenosis with crowding of the cauda equina. Mild bilateral foraminal narrowing. No interval changes. L3-4: Facet arthropathy. Minimal bulging disc. Moderate generalized spinal canal stenosis with crowding of the cauda equina. Moderate bilateral foraminal narrowing. No interval changes. L4-5: Facet arthropathy. Minimal bulging disc. No significant spinal canal stenosis. Moderate left and mild right foraminal narrowing. No interval changes. L5-S1: No significant spinal canal stenosis or neuroforaminal narrowing.
1.An enhancing nodule in the right retrocrural space at T12 is redemonstrated showing no significant interval change. This lesion could represent a pathologic lymph node, or given the history of multiple myeloma, a plasmocytoma.2.No definite pathologic marrow space lesions are seen. Signal abnormality within the T3 vertebral body is favored to represent an atypical hemangioma. Vertebral body morphology is within normal limits. There are no compression deformities.3.Scattered degenerative findings are noted as discussed above. Areas of mild to moderate spinal canal stenosis are seen. No significant interval change is noted.