Smoldering multiple myeloma There is a variegated/'salt-and-pepper' pattern of the bone marrow on T1-weighted imaging involving the pelvis, lower lumbar spine, and to a lesser degree, the proximal femora. Although this pattern has been described in patients with multiple myeloma it is nonspecific and we see no dominant enhancing focus to confirm multiple myeloma. There is normal marrow signal on fat-suppressed T2-weighted images and on postcontrast sequences. Mild osteoarthritis affects both hips. There is no evidence of synovitis or other areas of abnormal enhancement following contrast. The muscles of the pelvis appear normal in caliber and signal.
Variegated/salt-and-pepper pattern of bone marrow on T1 images which has been described in patients with multiple myeloma but is nonspecific. There are no focal dominant or enhancing lesion to confirm multiple myeloma.