Back pain. Compression fracture. Suspicion of cord compression. Examination is obtained of the total spine per limited cord compression protocol.Diffuse marrow heterogeneity is noted consistent with known multiple myeloma. There is a mild compression fracture along the superior endplate of T5. There is a relatively worse compression fracture along the superior endplate of T12 with approximately 50% loss of height and minimal retropulsion involving the superior endplate. Vertebral body heights are otherwise maintained. Alignment is grossly maintained. Fractures are not associated with retropulsion or soft tissue component. Diffuse edema is noted involving the L1 spinous process likely related to myelomatous involvement.There is partial ankylosis involving the C4 and C5 vertebral bodies with disc osteophyte complex at C5-C6 mildly narrowing the spinal canal. No definite cord signal abnormality. There is no significant thoracic or lumbar neural foraminal stenosis.
1. No cord compression is identified. Please note this is a limited exam specific for the exclusion of cord compression only and does not exclude more subtle lesions such as intrinsic cord abnormalities. Due to the screening nature of this protocol, details are not as evident on imaging as dedicated protocols of the spine.2. Diffuse heterogeneous marrow abnormality is compatible with the diagnosis of multiple myeloma.3. Pathologic compression fractures involving the T12 and T5 vertebral bodies as above without significant spinal canal stenosis.4. Mild spinal canal stenosis C5-6.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.