Reason: known plamacytoma in S1, r/o progression compared to Jan 2015 MRI History: known plamacytoma in S1, r/o progression compared to Jan 2015 MRI MRI thoracic spine:There is diffuse patchy marrow replacement throughout the visualized thoracic spine there is mild super endplate compression at T10.The thoracic vertebral bodies are appropriate in the overall alignment. The thoracic spinal cord has normal signal characteristics and overall morphology. There is no compromise of thoracic spinal canal or exiting nerve roots. Lumbar spine:Five lumbar type vertebral bodies are presumed to be present which are appropriate in overall alignment. The conus medullaris on sagittal imaging is grossly intact. There are multiple patchy foci of marrow replacement throughout the lumbar spine associated with a superior endplate compression at the L1, L2 and L3 vertebral bodies where there is mild loss perch or body height.There is patchy marrow replacement also present in the sacrum and iliac bones. There is extra osseous extension of neoplasm from the sacrum into the left S1 neural foramen where there is encroachment of the nerve root.There is multilevel disk desiccation present.At L5-S1 there is no significant compromise to spinal canal or neural foramina. There is a mild disk bulge present at this level.At L4-5 there is no significant compromise to spinal canal or neural foramina.At L3-4 there is no significant compromise to spinal canal or neural foramina.At L2-3 there is no significant compromise to spinal canal or neural foramina.At L1-2 there is no significant compromise to spinal canal or neural foramina.
1.Diffuse patchy marrow replacement throughout the visualized lumbar and thoracic spine is compatible the patient's diagnosis of multiple myeloma.2.There is extra osseous extension of neoplasm from the sacrum into the left S1 neural foramen where there is encroachment of the nerve root.3.There are mild compression fractures present at T10, L1, L2 and L3