Multiple myeloma patient on clinical drug trial with increasing hip pain, specifically left-sided lately. Evaluate for further degenerative changes versus myeloma lesions. The vertebral column alignment is within normal limits. There is significant central compression spanning nearly the full height of the L4 vertebral body centrally, but less severely laterally, similar to PET/CT of 1/2/2015. The disc space heights are preserved. The vertebral bone marrow signal is mildly heterogeneous, but without discrete lesion. There is no significant spinal canal stenosis. The distal spinal cord and conus are within normal limits with the conus terminating at the L2 level. There is no abnormal enhancement. The paravertebral soft tissues are unremarkable. There are small bilateral renal cysts.T12-L1: No significant disc bulge, spinal canal or foraminal stenosis. L1-L2: Tiny right paracentral disc protrusion, bilateral facet degeneration and thickening of the ligamentum flavum. No significant spinal canal or foraminal stenosis. L2-L3: Mild disc bulge asymmetric to the left, bilateral facet degeneration and thickening of the ligamentum flavum, contributing to mild left foraminal narrowing. No significant spinal canal stenosis. L3-L4: Disc bulge, bilateral facet degeneration and thickening of the ligamentum flavum, contributing to mild indentation of the ventral thecal sac and mild bilateral foraminal stenosis. No significant spinal canal stenosis. L4-L5: Mild disc bulge, bilateral facet degeneration and thickening of the ligamentum flavum, contributing to mild bilateral foraminal narrowing. No significant spinal canal stenosis. L5-S1: Disc bulge with annular fissure, bilateral facet degeneration and thickening of the ligamentum flavum, contributing to mild right and mild to moderate left foraminal stenosis. No significant spinal canal stenosis.
1. No significant interval change in the L4 compression fracture compared to the PET/CT of 1/2/2015. 2. No evidence of myelomatous disease.3. Mild to moderate degenerative changes of the lumbar spine as described above, most prominent at L3-4, with mild indentation of the ventral thecal sac and mild bilateral foraminal stenosis. No significant spinal canal stenosis. 