Reason: Hx Multiple Myeloma; new onset back pain. Evaluate for myeloma lesions. History: Hx Multiple Myeloma; new onset back pain. Evaluate for myeloma lesions. Note is made of diffuse heterogeneous bone marrow signal abnormality within the imaged bones of the pelvis lower lumbar spine, and proximal femora. These findings likely represent residual islands of red marrow. No discrete myelomatous deposits are identified. The imaged musculature of the pelvis is unremarkable. Although this examination was not protocoled for detailed evaluation of the pelvic viscera, no acute abnormality is identified. There is a small amount of peritrochanteric inflammation, left greater than right which may be of no clinical significance. There is a 6 x 8 x 16 mm enhancing focus of increased signal abnormality and fluid sensitive sequences within the subcutaneous tissue abutting the lateral aspect of the right gluteal musculature. Tiny focus of enhancing signal abnormality in the right superior iliac bone adjacent to the sacroiliac joint may represent a site of prior bone marrow biopsy. There is a small amount of fluid within the hips bilaterally which is not necessarily of any clinical significance.
1. Diffuse heterogeneous bone marrow signal abnormality may represent islands of red marrow. No discrete myelomatous deposits are identified.2. Nonspecific 16 mm enhancing nodule within the subcutaneous tissue along the lateral aspect of the right gluteal musculature. A soft tissue myelomatous deposit is considered unlikely.