Question 2230
{"accessible":false,"alternatives":[{"id":11043,"text":"metastatic breast cancer"},{"id":11044,"text":"metastatic thyroid cancer"},{"id":11045,"text":"multiple myeloma"},{"id":11046,"text":"polyostotic Paget disease of bone"},{"id":11047,"text":"secondary lymphoma of bone"}],"archived":false,"correctAlternativeId":11043,"explanation":"\u003cp\u003eThe most likely cause for the multiple aggressive sclerotic lesions described would be osteoblastic metastatic disease, of which breast cancer would be most common in a female patient. In male patients, prostate cancer would be most likely.\u0026nbsp;\u003c/p\u003e\u003cp\u003eMedullary thyroid cancer can produce sclerotic metastases however it is far less common than breast cancer.\u0026nbsp;Multiple myeloma would produce lytic lesions although treated myeloma can become sclerotic. Secondary lymphoma of bone can produce multiple sclerotic bone lesions however it is far less common than breast cancer. Polyostotic Paget disease would not typically appear aggressive and would usually have distinctive features (cortical thickening, coarsened trabeculae).\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u003c/p\u003e","id":2230,"imageUrl":null,"imageAttribution":null,"imageAttributionCaseInfo":null,"firstQuestionPath":"/questions/2240","nextQuestionPath":"/articles/bone-metastases-1/questions/1833","relatedArticles":[{"id":9555,"title":"Multiple myeloma","link":"/articles/multiple-myeloma-1?lang=us"},{"id":1824,"title":"Paget disease (bone)","link":"/articles/paget-disease-bone?lang=us"},{"id":90581,"title":"Bone lymphoma","link":"/articles/bone-lymphoma?lang=us"}],"alsoUsedIn":[{"id":1794,"kind":"Course","title":"X-ray Interpretation: Pelvis \u0026 Hip Injuries - page 1794","link":"https://radiopaedia.org/courses/x-ray-interpretation-pelvis-hip-injuries/pages/1794"},{"id":1119,"kind":"RestrictedPage","title":"Page 1119 (in no courses)","link":"https://radiopaedia.org/admin/restricted_pages/1119"},{"id":2086,"kind":"Course","title":"2024 Virtual Conference Private Use - page 2086","link":"https://radiopaedia.org/courses/2024-virtual-conference-private-use/pages/2086"},{"id":2086,"kind":"Course","title":"X-ray Interpretation: Bone Lesions Peer Review - page 2086","link":"https://radiopaedia.org/courses/x-ray-interpretation-bone-lesions-peer-review/pages/2086"},{"id":2086,"kind":"Course","title":"X-ray Interpretation: Bone Lesions - page 2086","link":"https://radiopaedia.org/courses/x-ray-interpretation-bone-lesions/pages/2086"}],"stem":"\u003cp\u003eA 55-year-old female has multiple aggressive sclerotic vertebral and pelvic bone lesions identified on x-ray. What would be the most likely cause?\u003c/p\u003e","menuLinks":[{"text":"Report problem with question","url":"https://docs.google.com/forms/d/e/1FAIpQLSfO3soWYhOjJ7yErSysyCe5V4A1CqW7WK3rDA7MtAkecMGqNw/viewform?entry.1624461248\u0026entry.553583435=https://radiopaedia.org/questions/2230"}],"attemptsPercentages":[{"alternativeId":"11044","percentage":2},{"alternativeId":"11047","percentage":1},{"alternativeId":"11045","percentage":6},{"alternativeId":"11046","percentage":6},{"alternativeId":"11043","percentage":84}],"promptToLogin":false,"questionManager":false,"articleId":"bone-metastases"}