Radiologist says maybe atypical spinal hemangioma but multiple myeloma can't be ruled out. what does this mean?

Talk to doc: An online consultation is not what you need. Whosoever ordered whichever test that showed the bone abnormality needs to go over it with you and determine what other test (if any) are indicated. Hopefully is nothing serious.

Usually nothing: I see this quite often. I think mostly it is from radiologists mentioning every possibility without knowing anything else about the patient. These patients will usually get further workup, such as a bone scan, and I have yet to find a malignancy this way. That's not to say it isn't possible though.

Often benign: While it is often true that the work up for atypical hemangioma results in a benign finding it is important to have further workup as malignancy cannot be excluded. Further workup may include MRI with contrast, bone scan or ct.