Myeloma with pathological fracture

Case contributed by Dr Derek Smith

Presentation

Known myeloma with diffuse skeletal deposits. Worsening right leg pain, especially on weightbearing.

Patient Data

Age: 80 years
Gender: Male
X-ray

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.

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Case information

rID: 62101
Published: 1st Aug 2018
Last edited: 14th Aug 2019
Inclusion in quiz mode: Included

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