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Myeloma patient. Has retropulsion of the posterior vertebral body. Is this traumatic?

I am a myeloma patient - in a recent skeletal survey the radiologist said this: Appears to be some retropulsion of the posterior aspect of the T7 vertebral body, unchanged. This could be post traumatic in nature but would be unusual as this portion of the thoracic cage is well protected. Therefore suspicion of replacement by plasma cell lesion is likely. Do you agree with this?
Asked On : Wed, 6 Mar 2013
Answers:  2 Views:  69
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Internal Medicine Specialist 's  Response
Dear friend, welcome and thanks for entrusting your query here at HCM!
I am Dr. Prasad Akole (Critical Care Expert- and am glad to address to your query here.

Trauma is the commonest logical cause of a vertebra being pushed back on to the next one, being strongly connected to each other.
However, as in your case, if there is a likelihood of disease infiltration (by myeloma) of the vertebra, it does not remain as strong and can cause retropulsed appearance even without or with slightest trauma.
So, I do agree with the radiology impression. And they are reporting a film. A clinician is the person who examines and knows the patient and gives opinion on its importance.

Please be guided by your treating doctor.

I hope to have answered your query satisfactorily. I would be glad to answer any further queries.
Please ask for any clarifications before closing and rating this answer.
Take care and please keep me informed of your progress at
Good Luck! Thank you!!
Answered: Sun, 10 Mar 2013
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Radiologist Dr. Muhammad Shoyab's  Response
Yes, I do agree, and I'd also appreciate the depth of thought of your radiologist. Indeed, when he looked at your MRI, he didn't look at a plastic film — he had "you" in mind.

However, reading from the report (and without looking at your MRI), I feel that his comment "replacement by plasma cell lesion is likely" is more of a caution than of a possibility. He wrote it so that your clinician doesn't totally exclude the possibility of T7 being invaded by myeloma.

In my opinion, the next step would be to go back to your clinician and discuss with him whether there is any need to further evaluate the T7 vertebra for possible "replacement by plasma cell lesion". This process can be much easier for you if you upload your MRI films in this forum, so that we can have a look at it and can give you a more informed opinion.

I'd welcome further queries for clarification from you. You can easily "ask me a question" by clicking the button above.

Wish you overcome your difficulties and live a peaceful life.
Answered: Thu, 7 Mar 2013
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Disclaimer: These answers are for your information only and not intended to replace your relationship with your treating physician.
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