Multiple myeloma

Case contributed by Dr Safwat Mohammad Almoghazy

Presentation

Bone pain, especially in her spine.

Patient Data

Age: 80 years
Gender: Female
X-ray

Skeletal survey

Skeletal survey revealed:

  • multiple well-defined "punched out" lytic lesions predominantly affecting the axial skeleton, most evident in the skull
  • no evidence of complications such as fractures or paraspinal soft tissue
  • mild diffuse skeletal osteopenia (which can also be age-related)
  • degenerative joint disease in both knee joints
  • atelectatic band versus thickened transverse fissure in lower zone of right lung
  • calcific nodule on lateral lumbar spine radiograph: suspected renal calculus

Case Discussion

This case was diagnosed as multiple myeloma by laboratory tests and clinically and demonstrates the typical radiographic presentation and age at presentation.

The main differential for multiple myeloma is widespread bone metastases.

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