Lower back pain, left hip pain, rule-out new myeloma this lesion Five lumbar type vertebral bodies are presumed to be present. Multiple compression fractures are seen including T12, L3, L4, and L5, worst at T12 where there is approximately 50% loss of height. These are new since 4/29/2013 but do not demonstrate significant marrow edema to suggest recent loss of height. There is mild anterolisthesis of L4 and L5 and minimal retrolisthesis of L5 on S1. Alignment of the lumbar spine is otherwise maintained. Bone marrow signal is heterogeneous compatible with history of multiple myeloma. There is enhancing lesion involving primarily the posterior elements of the T12 vertebra which is significantly decreased in size from 4/29/2013. Numerous additional smaller enhancing lesions have also regressed compared to 4/29/2013. No new lesion is definitively appreciated. No evidence of epidural tumor.Multilevel degenerative changes are seen, as described below:T12-L1: T12 compression fracture with up to approximately 50% loss of height as mentioned above. No significant disk disease. There is mild bilateral neural foraminal stenosis. No significant spinal canal stenosis.L1-L2: No significant spinal canal or neural foraminal stenosis.L2-L3: No significant spinal canal or neural foraminal stenosis.L3-L4: There is mild bilateral neural foramina narrowing, relatively worse on the right related to mild disk bulge and facet arthropathy. No significant spinal canal stenosis.L4-L5: There is mild spinal canal stenosis related to mild anterolisthesis, small disk bulge, advanced bilateral facet arthropathy, and ligamentum flavum thickening. There is moderate right neural foramina stenosis and mild left neural foramina stenosis.L5-S1: There is mild to moderate right and moderate left neural foramina stenosis related to diffuse disk bulge and advanced facet arthropathy. No significant spinal canal stenosis.Paraspinous soft tissues are within normal limits.
1. No recent MRI is available for comparison. Compared to 4/29/2013, there is been regression of numerous enhancing lesions with residual enhancing lesion involving the posterior elements of T12 again identified.2. Multiple compression fractures involving the T12, L3, L4, and L5 vertebral bodies, worst at T12 where there is up to 50% loss of height. These appear to be chronic but are new since 2013. 3. Multilevel degenerative changes including mild spinal canal stenosis at L4-5 and variable neural foraminal narrowing as detailed above.4. Multilevel facet arthropathy, worst at L4-L5 and L5-S1, which may be contributing to low back pain. There is mild L4-L5 anterolisthesis.