Sternal fracture

Case contributed by Ian Bickle
Diagnosis certain


Myeloma. Rapidly rising paraprotein. New anterior chest pain sited on the sternum. Lytic lesions?

Patient Data

Age: 85 years
Gender: Male

Disruption of the anterior and posterior cortex of the distal third of the sternum.

No underlying lytic bone lesion.

Case Discussion

Although on this plain radiograph no underlying myelomatous lesion is discernable, in the context of known multiple myeloma and no history of trauma, it is highly likely this is a pathological fracture.

The sternum is one of the harder components of the skeleton to fracture even in the context of trauma so the absence of injury, in this case, is highly suspicious.

Sternal radiographs are not performed terribly frequently and almost always for trauma.

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