Reason: smoldering myeloma, with ? Transformation to myeloma. R/o bone lesions History: none There is heterogeneity of the bone marrow affecting the pelvis, proximal femora, and visualized lower lumbar spine in a manner keeping with residual red marrow, although it is impossible for us to exclude low tumor burden. We see no definite focal lesion to confirm multiple myeloma. Mild osteoarthritis affects both hips, better seen on recent radiographs. Degenerative disc disease affects the visualized lumbar spine. The sacroiliac joints and pubic symphysis appear normal.
Heterogeneity of the medullary cavity of the visualized bone is favored to represent residual red marrow. Although it is impossible to entirely exclude low tumor burden, we see no focal lesion to confirm multiple myeloma.