Multiple myeloma x ray
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American Roentgen Ray Society Images of Multiple myeloma x ray |
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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.[1][2]
X-ray
- Simple radiography is the current gold standard for the initial diagnosis and evaluation of lytic lesions of multiple myeloma.[1]
- The long bones and the spine must always be evaluated while the evaluation of other bones merit consideration based on the patient's symptoms.[1]
- 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:[1]
- 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.[1]
- 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.
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X ray showing hair on end appearance.
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X ray spine showing collapsed vertebrae.
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X ray spine showing increased space between 2 vertebrae suggestive of possible malignancy.
