Subsequent myeloma work-up with a radiographic bone survey
redemonstrated multiple osteolytic lesions throughout the lumbar spine, pelvis, and bilateral proximal femurs (Figure 4).
showed the diffused decreasing bone density, fractured right clavicle, multiple lytic lesions among the cranium, humerus, clavicle, iliac, and pubic bone (Figure 2 and Figure 3).
indicated significant bone demineralization and arthritic changes with repeat demonstration of the lytic lesion at C2.
Conventional radiography or bone survey
has traditionally been the most common imaging modality in multiple myeloma; however there are numerous and increasing reasons why radiography alone is no longer adequate.
A bone survey
was performed and did not identify any lytic or blastic lesions.
To distinguish Graves' disease and Mc Cune Albright syndrome, TSH receptor antibody (TRAb) level and bone survey
(X-ray) were evaluated.
A long bone survey
demonstrated patchy intramedullary sclerosis in symmetric distribution affecting the shafts and metaphyseal portions of the bilateral radii, ulnae, femurs, tibiae, and fibulae with bilateral humeral sparing (Fig.
Other investigations showed a low parathyroid hormone (PTH), normal thyroid test, normal serum protein electrophoresis (SPEP), no evidence of multiple myeloma in bone survey
, and normal ultrasound of his kidneys.
To confirm the diagnosis ofextramedullary plasmacytoma, it is necessary to exclude the diagnosis of multiple myeloma by performing serum protein electrophoresis, a Bence ]ones protein analysis in the urine, a bone survey
, and a bone marrow biopsy.
The radiologist's interpretation process for total-body imaging is similar to a bone survey
for metabolic diseases, such as Paget disease of the bone or multiple myeloma.
In July 1999, follow-up bone survey
showed multiple lyric bone lesions involving the thoracic and lumbar spine and a sclerotic lesion overlying the sacroiliac joint.
It has been suggested but not yet demonstrated that these patients might have early bone involvement or micrometastases that cannot be detected, even with bone scan or bone survey