 Both the cervical and lumbar spine MRIs demonstrate diffuse marrow heterogeneity demonstrating atypical T1 hypointensity admixed with speckled foci of enhancement within the visualized marrow spaces. This finding is consistent with a diffuse marrow replacement process and would be consistent with the EMR history of myelofibrosis with myeloid metaplasia.Cervical spine:There is reversal of normal upper cervical curvature. The cervical cord is normal in signal without abnormal enhancement. The cervicomedullary junction is normal. The cerebellar tonsils are in normal position. The visualized paraspinal contents are unremarkable.C2/3: Trace anterolisthesis C2 on C3 and left facet hypertrophy without stenosis.C3/4: Posterior osteophyte disc complex and uncinate hypertrophy without stenosis.C4/5: Posterior osteophyte disc complex and uncinate hypertrophy (right greater than left). There is mild right neural foraminal stenosis. C5/6: Posterior osteophyte disc complex, uncinate hypertrophy (right greater than left), and ligamentum flavum thickening. There is moderate right neural foraminal stenosis.C6/7: Posterior osteophyte disc complex and uncinate hypertrophy without stenosis.C7/T1: UnremarkableLumbar spine:There are no acute fractures. The conus is normal in signal and morphology and terminates at an appropriate level. Note is made of bilateral renal cysts as demonstrated on previous abdomen MRI. Otherwise the visualized intra-abdominal and paraspinal contents are unremarkable. There is no abnormal enhancement of the conus or cauda equina.T12/L1: UnremarkableL1/2: UnremarkableL2/3: Mild disc bulge and mild bilateral facet hypertrophy without stenosis.L3/4: Trace retrolisthesis L4 on L5, mild disc bulge, moderate left facet hypertrophy, and mild right facet hypertrophy without stenosis. There are bilateral facet effusions, left greater than right.L4/5: Asymmetric bulge to the right, moderate to severe left facet hypertrophy and moderate right facet hypertrophy. There is a 7 x 6 mm synovial cyst posterior lateral to the right facet joint. There is minimal right neural foraminal stenosis.L5/S1: Grade 1 anterolisthesis L5 on S1, bilateral pars interarticularis defects, diffuse annular disc bulge with disc uncovering, severe left facet hypertrophy, and moderate to severe right facet hypertrophy. There is mild to moderate left neural foraminal and mild right neural foraminal stenosis.
1.Both the cervical and lumbar spine MRIs demonstrate diffuse marrow heterogeneity demonstrating atypical T1 hypointensity admixed with speckled foci of enhancement within the visualized marrow spaces. This finding is consistent with a diffuse marrow replacement process and would be consistent with the EMR history of myelofibrosis with myeloid metaplasia.2.C4/5: Mild right neural foraminal stenosis. 3.C5/6: Moderate right neural foraminal stenosis.4.L4/5: Minimal right neural foraminal stenosis.5.L5/S1: Grade 1 anterolisthesis L5 on S1 secondary to bilateral pars interarticularis defects. There is mild to moderate left neural foraminal and mild right neural foraminal stenosis.6.Facet hypertrophy with facet effusions as described in detail above.