Myelomatous rib lesion

Case contributed by Dr Ian Bickle

Presentation

Stem cell treatment for multiple myeloma 5 years prior. CXR for work purposes.

Patient Data

Age: 55 years
Gender: Male
X-ray

Expansile lucent 'bubbly' lesion in the posterior aspect of the left 5th rib.

No other thoracic cage lesion.

Lungs clear.

Case Discussion

In this case, a medical history was identified for this non-illness based film after inquiry with the patient.

If this was a de-novo lesion a differential for a lucent rib lesion should be followed. In fact, a popular film for fellowship viva examinations.

Because:

1.  one needs to spot it (bones important review area of CXR); tests observation

2.  give a sensible description of the findings; test of candidates descriptive skills

3.  give a sensible differential; several for a lucent rib lesion from benign to malignant

4.  check the candidate's advice/management skills

'What would you do next'? Tests if practical advice is given to help the clinician.

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Case information

rID: 48416
Published: 8th Oct 2016
Last edited: 11th Jan 2019
System: Chest
Inclusion in quiz mode: Included

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