Presentation
Known myeloma with diffuse skeletal deposits. Worsening right leg pain, especially on weightbearing.
Patient Data
Age: 80 years
Gender: Male
From the case:
Myeloma with pathological fracture
{"current_user":null,"step_through_annotations":true,"access":{"can_edit":false,"can_download":true,"can_toggle_annotations":true,"can_feature":false,"can_examine_pipeline_reports":false,"can_pin":false},"extraPropsURL":"/studies/70197/annotated_viewer_json?lang=us"}
Multiple lytic lesions with scalloping of the long bone cortices.
Periosteal reaction along the lateral aspect of the proximal tibia, with a smaller posteromedial component.
This supports the history and is consistent with a pathological fracture through a myelomatous deposit.
Case Discussion
Disseminated lytic lesions should make you think of myeloma. If there is a history of pain, look carefully for evidence of fracture or a healing fracture as in this case.