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Published byRosa Anthony Modified over 9 years ago
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Student SYB Chet Cunha MS IV February 4, 2009
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History 75 y/o M admitted for progressive weakness, inability to get out of bed. C/o R sided lower leg pain
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Plain films Right leg
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DDx lytic bone lesion Multiple myeloma Mets (breast, lung, kidney, thyroid) Eosinophilic granuloma (histiocytosis X) Brown tumor (hyperparathyroid) Benign bone lesions - endochondroma, chondroblastoma
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Multiple Myeloma B lymphocyte defect Diffuse osteopenia Renal insufficiency Anemia Recurrent infection Can progress to amyloidosis
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Multiple Myeloma Hypercalcemia Nongap acidosis Rouleaux formation Bence Jones proteins in urine Increased ESR
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Multiple Myeloma Most common primary skeletal neoplasm Usually seen in vertebral column, ribs, skull, pelvis, and femora (axial skeleton) Typically multiple, discrete, small, lytic lesions Occasionally, seen as a single lytic lesion: plasmacytoma (solitary myeloma)
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Multiple Myeloma Skeletal survey CT MRI
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Further Reading Gourtsoyiannis, N.C., Ros, P.R. Radiologic-Pathologic Correlations from Head to Toe. Springer Publishing, Berlin 2005. Grossman, Z.D., Katz, D. S., et al. Cost-Effective Diagnostic Imaging. Mosby Elsevier, Philadelphia, 2006.
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Thank you!
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