Cord compression – multiple myeloma

Spinal cord compression. This patient with multiple myeloma presented with rapidly deteriorating lower limb weakness. An MRI whole spine was performed. The sagittal image on the left is from a STIR sequence, in which the signal from fat is suppressed. This makes abnormal marrow lesions, such as myeloma deposits and metastases, much more conspicuous. In this case, there are multiple high signal lesions throughout the vertebral marrow. There is also a pathological fracture of T1, which is compressing the spinal cord (arrow on magnified image, right).