Diagnosis: Malignant neoplasm of unspecified site of unspecified female breast. Dorsalgia, unspecifiedClinical question: Stage 4 Breast Cancer; Increased Back Pain; Tenderness on Palpation.Signs and Symptoms: Stage 4 Breast Cancer; Increased Back Pain; Tenderness on Palpation. Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment. The conus medullaris on sagittal imaging is grossly intact. There are multiple marrow replacing lesions present in the lumbar spine which demonstrate sclerosis on recent abdominal CT imaging. There is approximately 30% loss of vertebral body height of L2 which is similar to the CT exam from 10/30/2015. There is no resultant compromise to the spinal canal or exiting nerve roots appreciated. There is no associated soft tissue extension appreciated on this exam. There are associated contrast enhancement with these lesions. There is involvement of predominantly vertebral bodies but also some of the posterior elements.At L5-S1 there is no significant compromise to spinal canal or neural foramina.At L4-5 there is no significant compromise to spinal canal or neural foramina. There is mild ligamentum flavum hypertrophy present.At L3-4 there is no significant compromise to spinal canal or neural foramina.At L2-3 there is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina.
1.There are multiple sclerotic lesions throughout the lumbar spine compatible with sclerotic metastases which are associated with a compression fracture of L2. There is no compromise to the spinal canal or exiting nerve roots resulting from this at this time. There is a CT of the abdomen from 10/30/2015 which demonstrates these lesions as well and there is no obvious progression since that time.2.There are some mild degenerative changes present in the lumbar spine.