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{{Multiple myeloma}}
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==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.<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> In some cases, [[MRI]] may be needed if [[X-ray]] is insufficient for [[diagnosis]].
[[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 (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>
*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.<ref name="radio">Multiple myeloma. Radiopaedia (2015)http://radiopaedia.org/articles/multiple-myeloma-1 Accessed on September, 20th 2015</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.
*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]]).
*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 ===
=== Skeletal survey ===
*A typical [[skeletal survey]] consists of the following films:<ref name="radio">Multiple myeloma. Radiopaedia (2015)http://radiopaedia.org/articles/multiple-myeloma-1 Accessed on September, 20th 2015</ref>
*A typical [[skeletal survey]] consists of the following films:
:*Lateral [[skull]]
:*Lateral [[skull]]
:*Frontal [[chest]] film
:*Frontal [[chest]] film
Line 20: Line 20:
:*[[Femur]]
:*[[Femur]]
:*[[Humerus]]
:*[[Humerus]]
:*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.<ref name="radio" /> [[File:Lytic lesion in right forearm.jpg|alt=Lytic lesions in multiple myeloma|Lytic lesions in multiple myeloma|center|frame]]
:*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 [[Diagnosis|diagnostic]] modality for lytic [[lesions]]. In some cases, [[MRI]] may be warranted, as [[MRI]] has a higher sensitivity than [[X-rays|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.
<gallery>
Image:Multiple-myeloma-001.jpg|X ray showing hair on end appearance.
Image:Multiple-myeloma-002.jpg|X ray spine showing collapsed vertebrae.
Image:Multiple-myeloma-003.jpg|X ray spine showing increased space between 2 vertebrae suggestive of possible malignancy.
</gallery>


==References==
==References==
{{reflist|1}}
{{Reflist|2}}


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Latest revision as of 22:47, 29 July 2020

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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. In some cases, MRI may be needed if X-ray is insufficient for diagnosis.

X-ray

Skeletal survey

  • Shown below are images depicting the involvement of skull and spinal cord respectively in a case of multiple myeloma.

References

  1. Multiple myeloma. Radiopaedia (2015)http://radiopaedia.org/articles/multiple-myeloma-1 Accessed on September, 20th 2015
  2. Reisenbuckler C (2014). "Multiple myeloma and diagnostic imaging". Radiol Technol. 85 (4): 391–410, quiz 411–3. PMID 24614435.