Male 64 years old Reason: 64-year-old male with a history of multiple myeloma now with worsening low back and right hip pain There is diffuse signal abnormality and enhancement within the bone marrow of the pelvis, proximal femora, and lower lumbar spine. Although this is nonspecific, it is compatible with given history of myeloma, and new from prior MRI in 2014. There are several more focal and discrete lesions on T2 and STIR images.There is enlargement of the right gluteus medius muscle with increased signal intensity on T2 imaging and enhancement following gadolinium administration. There is also suggestion of increased vascularity on the coronal STIR sequence. Findings are compatible with myositis or tumor infiltration of the muscle. Tendons are intact. The right hip joint itself appears normal. There is generalized subcutaneous and intermuscular edema without enhancement. Hydroceles bilaterally. There is a small amount of free fluid in the pelvis.
1.Diffuse marrow abnormality which is nonspecific but compatible with given history of myeloma.2.Enlargement and abnormal signal intensity of the right gluteus medius muscle is nonspecific and suggestive of myositis, but we cannot exclude tumor infiltration of muscle.