Reason: Pt with metstatic lung cancer with known mets to spine s/p radiation to T-spine now with worsening back pain. Please evaluate for pathologic fracture History: back pain There are multiple marrow replacing lesions in the thoracic spine as well as the visualized portions of the cervical and lumbar spine. The largest ones in the thoracic spine appear to be at T8, T9 and T12. There is milder encroachment of the right T9-T10 neural foramen resulting from one of these lesions. Compared to the prior exam extraosseous extension previously associated with some of the lesions has regressed and the signal characteristics have changed.There is a mild/minimal T12 and T8 superior end plate compression present which was previously present. The rest of the thoracic vertebral bodies are appropriate in the overall height. The thoracic vertebral bodies are appropriate in the overall alignment. The thoracic spinal cord has normal signal characteristics and overall morphology. There is a right pleural effusion present.There is a right sided lung lesion present adjacent to the paravertebral space at the level of the carina. This was not present on the prior exam
1.Findings are compatible with diffuse metastases along the entire spine. Although there is some narrowing of the right T9-T10 neural foramen, there is no compromise to the spinal cord . Compared to the prior exam extraosseous extension previously associated with some of the lesions has regressed and the signal characteristics have changed.2.There is a mild/minimal T12 and T8 superior end plate compression present which is stable.3.There is a right pleural effusion present which is also new.4.There is a right sided lung lesion present adjacent to the paravertebral space at the level of the carina. Please refer to recent chest CT for comments.