Positive Findings on Bone Scan in Multiple Myeloma

Positive Findings on Bone Scan in Multiple Myeloma

Abstract and Introduction

Abstract

We report a case of multiple myeloma in which the bone lesions showed high uptake of technetium Tc 99m methylene diphosphonate on a bone scan. A review of the literature comparing the usefulness of conventional skeletal radiography and bone scans in diagnosing the osteolytic lesions of myeloma shows that bone scintigraphy, considered by many to have no role in the detection of osteolytic lesions of myeloma, is in fact more sensitive than radiography in detecting lesions in the ribs, scapula, and spine.

Introduction

Skeletal radiographs have been consistently recognized as more likely than bone scans to reveal lytic bone lesions of myeloma. This is based on the fact that osteolytic lesions in multiple myeloma occur with little reparative bone formation to be detected by radionuclide imaging. We report the case of a 66-year-old man with multiple myeloma and a high uptake of technetium Tc 99m methylene diphosphonate (MDP) on bone scanning. We also review the role of skeletal surveys and bone scintigraphy in the diagnosis of skeletal lesions in myeloma.