70-year-old female with smoldering myeloma and right-sided rib lesion seen on x-rays. Evaluate for bone lesions. There is a focus of increased signal abnormality on fluid sensitive sequences within the anterior aspect of the right fifth and sixth ribs at the level of the costochondral junction, best seen on sagittal images 64 through 72 of series 901. There are also lesions within the right anterior seventh rib at the level of the costochondral junction. There is an additional punctate focus of signal abnormality within the costal cartilage at this level as well. No foci of bone marrow signal abnormality are identified within the lateral aspect of the right fourth and fifth ribs to correspond to the findings seen on recent radiographs, however. There are numerous prominent axillary lymph nodes. No additional foci of bone marrow signal abnormality are identified. The imaged musculature and subcutaneous tissues is normal in appearance. Please note that this examination was not protocoled for detailed evaluation of the thoracic viscera or vessels.
Numerous nonspecific right-sided rib lesions as described above. While myelomatous deposits cannot be completely excluded, given the focality and distribution of these lesions the possibility of prior trauma to this region or costochondritis should be considered.