MGUS SKULL: No focal myelomatous lesions are identified.CERVICAL SPINE: No focal myelomatous lesions are identified. There is mild degenerative disc disease at C5-C6.THORACIC SPINE: No focal myelomatous lesions are identified. LUMBAR SPINE: No focal myelomatous lesions are identified.RIBS: No focal myelomatous lesions are identified.PELVIS: No focal myelomatous lesions are identified. Mild osteoarthritis affects the hips.UPPER EXTREMITY: No focal myelomatous lesions are identified. Note is made of fusion of the proximal radius and ulna bilaterally which likely reflects congenital synostosis.LOWER EXTREMITY: There is periosteal reaction noted along the right femur which is nonspecific in nature but may relate to osteonecrosis as seen on prior MRI of 5/27/2016. Note is also made of a linear metallic density within the soft tissues of the medial thigh compatible with a broken needle which was also evident on the MRI. Periosteal reaction is also noted along the left distal femoral metaphysis with an additional underlying lucency which may also be the sequela of osteonecrosis.There is a mildly depressed fracture of the right medial tibial plateau which extends through the medial condyle. There appears to be some small adjacent callus formation but there is no definite underlying lytic lesion. These findings may be secondary to underlying osteonecrosis as well.
1. No discrete myelomatous lesions.2. Mildly depressed fracture of the right medial tibial plateau which is further detailed above. These findings were discussed with the ordering physician, Dr. J. Godfrey, at the time of interpretation.