Myelomatous rib lesion

Case contributed by Dr Ian Bickle


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

Patient Data

Age: 57
Gender: Male

Expansile lucent 'bubbly' lesion in the posterior aspect of the left 4th 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 enquiry with the patient.

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


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 candidates advice/management skills.

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

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Case information

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

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