Reason: 59yr old male with history of MM; pre-auto sct evaluation History: evaluate SKULL: Multiple small lytic lesions are seen throughout the skull, compatible with a history of multiple myeloma.CERVICAL SPINE: The lower cervical spine is partially obscured. Degenerative changes affect the cervical spine. No discrete myelomatous lesion is evident. THORACIC SPINE: Compression deformity is again seen involving the T5 vertebral body, with approximately 60% loss of vertebral body height and areas of lucency within the vertebral body, compatible with known history of myeloma, appearing similar to that seen on previous MRI. Mild anterior wedge deformity is also seen is T8 vertebral body, and appears chronic. Degenerative disc disease affects the remainder of the thoracic spine.LUMBAR SPINE: Mild degenerative disc disease and facet arthropathy affect the lumbar spine. No discrete myelomatous lesion is evident.RIBS: Subtle lucency along the posterior aspect of the left second rib may represent a myelomatous deposit, but this is equivocal. Mild deformity and sclerosis along the posterolateral aspect of the right ninth rib may represent healing/healed pathologic fracture, possibly related to myelomatous lesion.PELVIS: There is a 5-6 cm lytic lesion with sclerotic margins in the right ilium as seen on previous CT. A healed pathologic fracture is visualized in the left ischium. Degenerative changes affect the bilateral hips. Surgical clips project over the scrotum.UPPER EXTREMITY: Subtle lucencies in the bilateral proximal humeri may represent additional myelomatous deposits, but this is equivocal. Deformity of the mid left clavicle may represent a healed fracture. No myelomatous deposits are seen within the forearms. Degenerative changes affect the bilateral acromioclavicular joints. LOWER EXTREMITY: Poorly defined 1 cm lucency within the distal femoral diaphysis bilaterally, suggestive of myelomatous deposits. Punctate high density foci are seen in the medial subcutaneous fat of the left thigh, of unknown etiology. No discrete myelomatous lesions are seen within the lower legs. An ossicle in the posterior left knee joint may represent a loose body.
Multiple myeloma and other findings as above.