Presentation
Left shoulder pain.
Patient Data
Age: 60 years
Gender: Female
From the case:
Pathological clavicle fracture - multiple myeloma
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Expansile lytic lesion through the distal clavicle with cortical disruption. Numerous other smaller lytic lesions throughout the clavicle and humerus.
From the case:
Pathological clavicle fracture - multiple myeloma
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CT confirms the distal clavicle lytic lesion with fracture. Better demonstrated are the numerous smaller lytic lesions, which are more extensively seen through the vertebrae and ribs as well as the humerus, scapula, and clavicle.
Case Discussion
In older patients, lytic lesions primarily carry a differential diagnosis of metastases, myeloma, and lymphoma. On further work-up, the cause in this patient was confirmed to be multiple myeloma, of which the shoulder pain was the first presentation.
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