60-year-old female patient with multiple vertebral fractures and focal pain in lumbar and thoracic spine. History of multiple myeloma. Thoracic Spine: Note that the patient has 11 thoracic type vertebrae and a transitional S1 vertebra. There is high T2 and T1 hyperintense lesion in T12 with peripheral enhancement and at least 50% compression deformity with slight focal kyphosis, but no significant retropulsion or neural foramen stenosis. There is diffusely abnormal signal within the bone marrow of the rest of the thoracic vertebral column and with multiple small foci of enhancement, but no evidence of associated pathological fractures elsewhere in the thoracic spine. The spinal cord displays normal signal and morphology. The paravertebral soft tissues are unremarkable. There is a septated left renal cyst. Lumbar Spine: There is an unchanged compression fracture of the L1 vertebral body with circumferential cortical step offs and cleft without significant spinal stenosis or neural foraminal compromise. There is unchanged compression fracture of L2 vertebrae with considerable loss of height and approximately 5 mm of retropulsion of the posterior vertebral body as well as contiguous disc material into the spinal canal with focal kyphotic angulation, but no significant spinal stenosis or neural foraminal compromise. The other lumbar vertebrae display heterogeneous signal characteristics, but no evidence of pathologic fracture. There is mild multilevel degenerative spondylosis in the lower lumbar spine and mild lumbosacral epidural lipomatosis without significant spinal stenosis or neural foraminal compromise.
Diffuse involvement of the imaged axial skeleton by multiple myeloma with no significant change in the pathological fractures involving the T12, L1, and L2 vertebrae, but no evidence of spinal cord or cauda equina compression.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.