Multiple myeloma x ray: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Multiple myeloma}} | {{Multiple myeloma}} | ||
{{CMG}} {{AE}}{{HL}} {{shyam}} | {{CMG}} {{AE}}{{HL}}; {{shyam}} | ||
==Overview== | ==Overview== | ||
X-ray may be helpful in the diagnosis of multiple myeloma. Findings on X-ray suggestive of multiple myeloma include punched out bony lesions, generalized [[osteopenia]], and hair-on-end appearance. | [[X-ray]] may be helpful in the [[diagnosis]] of [[multiple myeloma]]. Findings on [[X-ray]] suggestive of [[multiple myeloma]] include punched out bony [[lesions]], generalized [[osteopenia]], and hair-on-end appearance. In some cases, [[MRI]] may be needed if [[X-ray]] is insufficient for [[diagnosis]]. | ||
==X-ray== | ==X-ray== | ||
*Simple radiography is the current gold standard for the initial diagnosis and evaluation of lytic lesions of multiple myeloma.<ref name="radio">Multiple myeloma. Radiopaedia (2015)http://radiopaedia.org/articles/multiple-myeloma-1 Accessed on September, 20th 2015</ref> | *Simple [[radiography]] is the current [[Gold standard (test)|gold standard]] for the initial [[diagnosis]] and evaluation of lytic [[lesions]] of [[multiple myeloma]].<ref name="radio">Multiple myeloma. Radiopaedia (2015)http://radiopaedia.org/articles/multiple-myeloma-1 Accessed on September, 20th 2015</ref><ref name="pmid24614435">{{cite journal |vauthors=Reisenbuckler C |title=Multiple myeloma and diagnostic imaging |journal=Radiol Technol |volume=85 |issue=4 |pages=391–410; quiz 411–3 |date=2014 |pmid=24614435 |doi= |url=}}</ref> | ||
*The [[long bone]]s and the [[spine]] must always be evaluated while the evaluation of other bones merit consideration based on the patient's symptoms. | *The [[long bone]]s and the [[spine]] must always be evaluated while the evaluation of other [[bones]] merit consideration based on the patient's symptoms. | ||
*A series of plain films, or [[skeletal survey]], is essential in not only the diagnosis of multiple myeloma, but also in assessing response, and pre-empting potential complications (e.g. pathological fractures). A typical skeletal survey consists of the following films: | *A series of plain films, or [[skeletal survey]], is essential in not only the [[diagnosis]] of [[multiple myeloma]], but also in assessing response, and pre-empting potential [[complications]] (e.g. pathological [[Bone fracture|fractures]]). | ||
=== Skeletal survey === | |||
*A typical [[skeletal survey]] consists of the following films: | |||
:*Lateral [[skull]] | :*Lateral [[skull]] | ||
:*Frontal [[chest]] film | :*Frontal [[chest]] film | ||
| Line 17: | Line 20: | ||
:*[[Femur]] | :*[[Femur]] | ||
:*[[Humerus]] | :*[[Humerus]] | ||
*The vast majority of lesions seen on plain radiography are purely [[lytic]]. Lytic lesions are sharply defined and "punched-out" in appearance, with endosteal scalloping when abutting cortex. The lesions are sclerotic in only 3% of patients. | :*The vast majority of [[Lesion|lesions]] seen on plain [[radiography]] are purely [[lytic]]. [[Lytic]] [[lesions]] are sharply defined and "punched-out" in appearance, with endosteal scalloping when abutting cortex. The lesions are sclerotic in only 3% of patients. | ||
*The X-ray is the most inexpensive diagnostic modality for lytic lesions. In some cases, MRI may be warranted, as MRI has a higher sensitivity than X-ray. | *The X-ray is the most inexpensive [[Diagnosis|diagnostic]] modality for lytic [[lesions]]. In some cases, [[MRI]] may be warranted, as [[MRI]] has a higher sensitivity than [[X-rays|X-ray]]. | ||
*X-rays should be avoided in pregnant patients with multiple myeloma. MRI can be done instead. | *[[X-rays]] should be avoided in [[pregnant]] patients with [[multiple myeloma]]. [[MRI]] can be done instead. | ||
*Shown below are images depicting the involvement of [[skull]] and [[spinal cord]] respectively in a case of multiple myeloma. | *Shown below are images depicting the involvement of [[skull]] and [[spinal cord]] respectively in a case of multiple myeloma. | ||
==References== | ==References== | ||
{{ | {{Reflist|2}} | ||
[[Category: | [[Category:Medicine]] | ||
[[Category:Hematology]] | [[Category:Hematology]] | ||
[[Category:Neurology]] | [[Category:Neurology]] | ||
[[Category:Neurosurgery]] | [[Category:Neurosurgery]] | ||
[[Category:Oncology]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Surgery]] | |||
Latest revision as of 22:47, 29 July 2020
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Multiple myeloma Microchapters |
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Multiple myeloma x ray On the Web |
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American Roentgen Ray Society Images of Multiple myeloma x ray |
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Risk calculators and risk factors for Multiple myeloma x ray |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]; Shyam Patel [3]
Overview
X-ray may be helpful in the diagnosis of multiple myeloma. Findings on X-ray suggestive of multiple myeloma include punched out bony lesions, generalized osteopenia, and hair-on-end appearance. In some cases, MRI may be needed if X-ray is insufficient for diagnosis.
X-ray
- Simple radiography is the current gold standard for the initial diagnosis and evaluation of lytic lesions of multiple myeloma.[1][2]
- The long bones and the spine must always be evaluated while the evaluation of other bones merit consideration based on the patient's symptoms.
- A series of plain films, or skeletal survey, is essential in not only the diagnosis of multiple myeloma, but also in assessing response, and pre-empting potential complications (e.g. pathological fractures).
Skeletal survey
- A typical skeletal survey consists of the following films:
- Lateral skull
- Frontal chest film
- Cervico-thoraco-lumbar spine
- Shoulder
- Pelvis
- Femur
- Humerus
- The vast majority of lesions seen on plain radiography are purely lytic. Lytic lesions are sharply defined and "punched-out" in appearance, with endosteal scalloping when abutting cortex. The lesions are sclerotic in only 3% of patients.
- The X-ray is the most inexpensive diagnostic modality for lytic lesions. In some cases, MRI may be warranted, as MRI has a higher sensitivity than X-ray.
- X-rays should be avoided in pregnant patients with multiple myeloma. MRI can be done instead.
- Shown below are images depicting the involvement of skull and spinal cord respectively in a case of multiple myeloma.
References
- ↑ Multiple myeloma. Radiopaedia (2015)http://radiopaedia.org/articles/multiple-myeloma-1 Accessed on September, 20th 2015
- ↑ Reisenbuckler C (2014). "Multiple myeloma and diagnostic imaging". Radiol Technol. 85 (4): 391–410, quiz 411–3. PMID 24614435.