Multiple Myeloma

Multiple myeloma is a cancer in which abnormal cells called myeloma cells collect in the bone marrow and form tumors. If only one single tumor forms within the bone this is referred to as a plasmacytoma. Multiple myeloma occurs when these cells collect in multiple bones and forming more than one tumor. This type of disease generally affects patients above the age of 60. Symptoms may include back pain and kidney dysfunction. MRI scans are utilized for diagnosing multiple myeloma. Typical multiple myeloma appearance is low signal intensity on a T1 weighted image. On a T2 weighted image signal intensity is high. Multiple myeloma lesions some what enhance post injection of gadolinium injections. Mulitple myeloma may present in MRI's as other musculosketal tumors so other blood tests and or bone marrow aspirations will have to be utilized for proper diagnosis. Treatment may include chemotherapy and radiation therapy. The prognosis of patients with multiple myeloma are dependant upon success of treatment and how extensive the disease has progressed.

Schmorl's Nodes

I chose Schmorl's nodes since I do MRI and have clinically seen this pathology. Schmorl's nodes are believed to be associated with trauma but a possible congenital origin of a vertebrae end plate defect can not be ruled out. A Schmorl's node is a herniation to the nucleus pulposus of the intravertebral disk through the vertebral end plate. Most patients present with back pain and usually at the thoracolumbar junction. Most patients seem to be able to recall a time when they experienced trauma or a twinge of pain in their back during some type of movement. The injury may have occurred during a sport, exercising, or even moving something while twisting their back. Some Schmorl's nodes may show up on radiographs, but CT and MRI of the spine are the modality of choice. Once diagnosed, patients may be told to take an anti-inflammatory and told to stay away from strenuous activity. Rest will aid in the repair of the disk. Traction and newer developments of non surgical spinal decompression may also be utilized. Prognosis for most patients is very good. Patients may become for susceptible to this same type of pathology in the future.