multiple myeloma
TRANSCRIPT
Case discussions
Dr Subhash Kumar MD, DM Associate Consultant ‐Neuroradiology
70 yrs, M 1 wk h/o progressively increasing BL lower limb weakness and loss of sensation
No fever, trauma Not much pain O/E: vitals stable, afebrile, power: 1/5 BL LL, sensory level T8, plantar reflexes absent
Provisional diagnosis: fast progressing myelopathy : ?transverse myelitis
•ESR: 25mm/ 1st hr
T1
T2
106 mm/ 1st hr • Urine Bence Jones protein: negative
Multiple myeloma ??Metastasis
Bone marrow exam: normal
Appropriate investigations? Sequence of investigations? Myeloma Staging? Refinement in imaging studies? Follow up imaging protocol?
Patient was on steroids No soft tissue seen on surgery
MM