Multiple myeloma - femur

120 views580y Female10/9/2026

Clinical Presentation

Severe left sided hip pain. No trauma.

1Subtle focal lucencies in the region of the greater trochanter and subtle endosteal scalloping in the proximal and mid femoral diaphysis
2A fracture is not identified
3The patient was injected with 99m-Technetium MDP and initial dynamic (not shown) and whole body blood pool images obtained
4Whole body imaging were obtained 3 hours later.With respect to the left femoral head there is increased focal uptake involving the greater and lesser trochanters suspicious for fracture
5The distribution of uptake does not fit a usual pattern for neck of femur fracture
6Physiological bladder and pudendal uptake is noted.On the whole body blood pool images there is increased perfusion in the proximal left femur
7Delayed whole body images demonstrate multiple tracer hot spots involving the medial end of the left clavicle as well as the 2nd and 5th ribs anteriorly
8There are additional hot spots involving the right 3rd, 4th, 5th, 6th and 7th ribs anteriorly as well as increased tracer uptake in the vertebral body of T9
9There is a lytic expansile soft tissue attenuation mass in the intertrochanteric region of the left femur measuring 3.6 x 4.6 x 3.4 cm
10There is endosteal scalloping of the cortex with multiple intra-and trans-cortical lucencies indicating cortical infiltration