Multiple myeloma not having achieved remission [C90.00], Reason for Study: ^Reason: relapsed myeloma with new neck pain, xrays unrevealing, severe kyphosis History: neck pain Cervical spine MRIDue to motion artifact, image quality is degraded.There is exaggerated kyphotic angulation of cervical spine.At the level of C5, vertebral body signal intensity on T1 is a low and high signal on T2 and STIR images indicating acute compression fracture with about 10% height loss. Comparing to prior scan, this C5 compression fracture is new. Soft tissue lesions seen on prior scan posterior to the C5 body is not seen on today's scan.There is no evidence of retropulsion or abnormal spinal cord signal intensity. Next line however, at the level of C4-5, C5-6, there are moderate degree spinal canal stenosis due to ligamentum flavum thickening.Thoracic spine MRI.Again multiple compression fractures seen from T4 to T12.Previously identified discrete lesion at T4 vertebral body is not as conspicuous as it was before.Intravertebral body low signal intensity lesions at the level of T7, 8, 9 and 10 vertebral bodies indicating post cement augmentation procedure, unchanged.T6 vertebral body shows more than 70% of compression fracture with bone marrow edema, comparing to prior scan, no change of the degree of compression fracture as well as MR signal characteristics.Loss of normal fatty marrow signal intensity of thoracic vertebral bodies including about 20% of compression fracture of L1 vertebral body are again demonstrated, grossly unchanged since prior scan.Multifocal rib lesions are again seen, unchanged.Bilateral multifocal lung nodules and pleura based lesions are seen, unchanged since prior scan. There is no evidence of spinal stenosis.Spinal cord signal intensity is normal.
1. New abnormal bone marrow signal with about 10% of height loss at the level of C5 indicating acute compression fracture without evidence of retropulsion.2. Interval resolution of epidural soft tissue at the level of C5.3. Unchanged multi-level various degree compression fractures, post cement augmentations and cervical spinal stenosis since prior scan.4. No abnormal spinal cord signal intensity.