Female, 62 years old, with multiple myeloma and kyphosis with back pain. Patchy inhomogeneous marrow signal intensity is seen with areas of T1 hypointense and STIR hyperintense signal most pronounced in the L3, L4 and L5 vertebral bodies as well as the sacrum.Spinal alignment is anatomic. Mild, less than 50%, loss of vertebral body height is evident at L3 and L4. Mild superior endplate concavity of the L1 vertebral body is also seen. These findings have not substantially changed from the prior examination.The visualized distal spinal cord, conus and nerve roots of the cauda equina are unremarkable. No epidural abnormalities are suspected.L1-2: Right greater than left facet arthropathy. No significant spinal canal or foraminal stenosis. No interval changes. L2-3: Mild facet arthropathy. No significant spinal canal or foraminal stenosis. No interval changes. L3-4: Moderate facet arthropathy. Minimal disc bulging. No significant spinal canal stenosis. Mild left foraminal narrowing. No interval changes. L4-5: Moderate facet arthropathy. Mild bulging disc. No significant spinal canal stenosis but the left lateral recess is slightly effaced. Moderate left and mild right foraminal narrowing. No interval changes. L5-S1: Moderate bilateral facet arthropathy. Mild disc bulging asymmetric to the left. No significant spinal canal stenosis. Mild left foraminal narrowing. No interval changes.
1.Patchy abnormal marrow signal is seen most conspicuously affecting the lower lumbar spine and sacrum, similar to the prior examination, and compatible with multiple myeloma.2.Mild loss of height of the L1, L3 and L4 vertebral bodies is unchanged.3.Mild to moderate degenerative findings without significant change and without high-grade spinal canal stenosis.