New diagnosis of multiple myeloma: saddle anesthesia, right hip and buttock pain, and acute renal failure. There is degenerative spondylosis in the cervical spine, particularly at C3-4 and C4-5, with mild indentation of the spinal cord. Patchy high T2 signal projecting over the spinal cord in this region may be artifactual or may represent myelomalacia. There is a T2 hyperintense mass within the posterior aspect of the T12 vertebral body with epidural extension associated with compression of the spinal cord. There is also mild deformity of the superior endplate of T12. There may be trace edema in the spinal cord at this level versus artifact. There is focal fat in the inferior T7 vertebral body. There appears to be a predominantly T2 hyperintense lesion in the superior portion of the L2 vertebral body with mild irregularity of the superior endplate. The vertebral column alignment is grossly intact. There is a partially-imaged mass arising from the right sacrum and iliac bone. The cerebellar tonsils are mildly low-lying.
1. Degenerative spondylosis in the cervical spine worse at C3-4 and C4-5 with mild indentation of the spinal cord. 2. A myelomatous deposit in the T12 vertebra with pathological fracture and epidural extension results in spinal cord compression.3. A lesion in the superior portion of the L2 vertebral body with mild irregularity of the superior endplate may represent an additional myelomatous deposit versus an intravertebral disc herniation, although characterization is limited without intravenous contrast. 4. Partially-imaged mass arising from the right sacrum and iliac bone. Please refer to the separate pelvis MRI report for additional details.5. Diffuse enlargement of the bilateral kidneys likely represents myelomatous infiltration.6. The cerebellar tonsils are mildly low-lying.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.