Multiple myeloma - right proximal femur

Case contributed by Henry Knipe
Diagnosis almost certain

Presentation

Right hip pain.

Patient Data

Age: 35-40 years
Gender: Female

Lytic bone lesion in the femoral neck with a permeative appearance to the cortex. No calcified periosteal reaction. Posteriorly there is a small extraosseous soft tissue mass with cortical erosion. No other bone lesion in the field of view. No inguinal lymphadenopathy. 

Case Discussion

The permeative cortical appearance is concerning and is mainly a differential of malignancy (e.g. multiple myeloma, lymphoma, sarcoma) and infection. After work-up, and despite the young age, this patient was diagnosed with multiple myeloma. 

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