Fatigue. Weight loss.
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Chest: Small lucent lesions in both clavicles. The lungs are clear.
Humeri: lucent lesions in both humeri.
Skull: pepperpot appearance
Pelvis: vague lucencies projected over the proximal femora
Spine: two fractured vertebral bodies in the upper thoracic spine, degenerative change
Lucent lesions throughout the bony skeleton and two fractures in the upper thoracic spine - the differential is between metastases and myeloma.
Laboratory and histopathological investigations confirmed multiple myeloma.