Reason: smoldering myeloma new diagnosis, baseline MRI r/o lesions History: none Cervical spine:The cervical vertebral bodies are appropriate in overall alignment and height. The cervical spinal cord has normal signal characteristics and overall morphology. Overall the marrow signal is somewhat mottledNo abnormal enhancing lesions are appreciated in the cervical spine.At C2-3 there is no significant compromise to the spinal canal or neural foramina.At C3-4 there is no significant compromise to the spinal canal or neural foramina. There is a disk bulge present at this level.At C4-5 there is no significant compromise to the spinal canal or neural foramina. There is a disk bulge present at this level.At C5-6 there is no significant compromise to the spinal canal. There is a disk bulge present at this level. There is some associated narrowing of the right neural foramen at this level due to disk materialAt C6-7 there is no significant compromise to the spinal canal or neural foramina.At C7-T1 there is no significant compromise to the spinal canal or neural foramina.The vertebral artery flow voids appear to be intact.MRI thoracic spine:The thoracic vertebral bodies are appropriate in the overall alignment and height. The thoracic spinal cord has normal signal characteristics and overall morphology. There is no compromise of thoracic spinal canal or exiting nerve roots. There is diffuse marrow replacement present.No abnormal enhancing lesions are appreciated in the throacic spine.Lumbar spine:Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment and height. The conus medullaris on sagittal imaging is grossly intact. There is diffuse marrow replacement present.No abnormal enhancing lesions are appreciated in the lumbar spine.At L5-S1 there is no significant compromise to spinal canal or neural foramina.At L4-5 there is diffuse disk bulge present associated bilateral facet ligamentum flavum hypertrophy and effacement of the fat of the lateral recesses bilaterally. Overall there is a mild to moderate degree of spinal stenosis at this level. There is mild narrowing of the neural foramina at this level.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.Overall the marrow signal is diffusely low . This is a nonspecific finding can but can be seen with myeloproliferative disorders as per the patient's clinical history.2.There are degenerative changes present in the cervical spine worse at C5-6 where there is some encroachment of the right-sided exiting nerve roots due to disk material3.There are degenerative changes present in the lumbar spine worse at L4-5 where there is a mild to moderate degree of spinal stenosis