eMedicine Specialties > Radiology > Musculoskeletal

Multiple Myeloma: Follow-up

Author: Steven M Sorenson, MD, Consulting Staff, Department of Radiology, Coast Radiology Imaging and Intervention
Coauthor(s): Amilcare Gentili, MD, Professor of Clinical Radiology, University of California at San Diego; Consulting Staff, Department of Radiology, Thornton Hospital; Chief of Radiology, San Diego VA Health Care System; Sulabha Masih, MD, Associate Professor of Diagnostic Radiology, University of California at Los Angeles; Consulting Staff, Department of Radiology, Section of Musculoskeletal Radiology, West Los Angeles Veterans Affairs Medical Center; Carol L Andrews, MD, Consulting Musculoskeletal Radiologist, Mink Radiologic Imaging; Consulting Staff, Department of Radiology, Antelope Valley Medical Center
Contributor Information and Disclosures

Updated: Aug 14, 2009

Intervention

Myeloma is treated with chemotherapy and, possibly, radiation. CT scanning may be used for percutaneous biopsy. Vertebroplasty has been suggested as a treatment for pathologic fractures within the spine. 

Images 8-12 show a myeloma lesion in the left glenoid that expanded over the course of 1 year. Because the coracoid process was involved, it was selected for biopsy (see Image 13).

Medicolegal Pitfalls

  • Failure to diagnose impending pathologic fractures
  • Failure to appreciate subtle myeloma lesions. If a patient presents only with a plasmacytoma, the discovery of only one additional myeloma lesion on a skeletal survey changes the staging from I to III.
 


More on Multiple Myeloma

Overview: Multiple Myeloma
Imaging: Multiple Myeloma
Follow-up: Multiple Myeloma
Multimedia: Multiple Myeloma
References
Further Reading
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References

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  2. O'Sullivan P, O'Dwyer H, Flint J, Munk PL, Muller NL. Malignant chest wall neoplasms of bone and cartilage: a pictorial review of CT and MR findings. Br J Radiol. Aug 2007;80(956):678-84. [Medline].

  3. Pérez-Persona E, Vidriales MB, Mateo G, et al. New criteria to identify risk of progression in monoclonal gammopathy of uncertain significance and smoldering multiple myeloma based on multiparameter flow cytometry analysis of bone marrow plasma cells. Blood. Oct 1 2007;110(7):2586-92. [Medline].

  4. Reece DE. Management of multiple myeloma: the changing landscape. Blood Rev. Aug 28 2007;epub ahead of print. [Medline].

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  7. Shortt CP, Gleeson TG, Breen KA, McHugh J, O'Connell MJ, O'Gorman PJ, et al. Whole-Body MRI versus PET in assessment of multiple myeloma disease activity. AJR Am J Roentgenol. Apr 2009;192(4):980-6. [Medline].

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  9. Agool A, Slart RH, Dierckx RA, Kluin PM, Visser L, Jager PL, et al. Somatostatin receptor scintigraphy might be useful for detecting skeleton abnormalities in patients with multiple myeloma and plasmacytoma. Eur J Nucl Med Mol Imaging. Jul 14 2009;[Medline].

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Keywords

multiple myeloma, plasma cell myeloma, myeloma, Bence-Jones protein, light chains, heavy chains, monoclonal gammopathy of unknown significance, MGUS, plasmacytoma, hypergammaglobulinemia, POEMS syndrome

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Contributor Information and Disclosures

Author

Steven M Sorenson, MD, Consulting Staff, Department of Radiology, Coast Radiology Imaging and Intervention
Steven M Sorenson, MD is a member of the following medical societies: Radiological Society of North America
Disclosure: Nothing to disclose.

Coauthor(s)

Amilcare Gentili, MD, Professor of Clinical Radiology, University of California at San Diego; Consulting Staff, Department of Radiology, Thornton Hospital; Chief of Radiology, San Diego VA Health Care System
Amilcare Gentili, MD is a member of the following medical societies: American Roentgen Ray Society, Radiological Society of North America, and Society of Skeletal Radiology
Disclosure: Nothing to disclose.

Sulabha Masih, MD, Associate Professor of Diagnostic Radiology, University of California at Los Angeles; Consulting Staff, Department of Radiology, Section of Musculoskeletal Radiology, West Los Angeles Veterans Affairs Medical Center
Sulabha Masih, MD is a member of the following medical societies: American Roentgen Ray Society, Radiological Society of North America, and Society of Skeletal Radiology
Disclosure: Nothing to disclose.

Carol L Andrews, MD, Consulting Musculoskeletal Radiologist, Mink Radiologic Imaging; Consulting Staff, Department of Radiology, Antelope Valley Medical Center
Carol L Andrews, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Forensic Sciences, American Association for Women Radiologists, American College of Radiology, American Medical Association, American Roentgen Ray Society, California Radiological Society, North American Spine Society, Radiological Society of North America, and Society of Skeletal Radiology
Disclosure: AMIRSYS publishing Royalty Independent contractor

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

Wilfred CG Peh, MD, MBBS, FRCP(Glasg), FRCP(Edin), FRCR, Clinical Professor, Faculty of Medicine, National University of Singapore; Senior Consultant Radiologist, Alexandra Hospital, Singapore
Wilfred CG Peh, MD, MBBS, FRCP(Glasg), FRCP(Edin), FRCR is a member of the following medical societies: American Roentgen Ray Society, British Institute of Radiology, International Skeletal Society, Radiological Society of North America, Royal College of Physicians, and Royal College of Radiologists
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Resolution Imaging Medical Corporation
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Felix S Chew, MD, MBA, EdM, Professor, Department of Radiology, Vice Chairman for Radiology Informatics, Section Head of Musculoskeletal Radiology, University of Washington
Felix S Chew, MD, MBA, EdM is a member of the following medical societies: American Roentgen Ray Society, Association of University Radiologists, and Radiological Society of North America
Disclosure: Nothing to disclose.

 
 
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