| Incidental Diagnosis of Multiple Myeloma during Conservative Treatment for Vertebral Fracture. |
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Woo Seok Sim, Byung Seop Shin, Yoon Jung Kang, Eun Jin Kim, Yong Chul Kim |
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Pain Management Center, Department of Anesthesiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. anesthe@smc.samsung.co.kr |
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| Abstract |
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A 42-year-old male came to our pain clinic for consultation for the control of pain caused by compression fractures at T12 and L1. About 2 months ago, the patient had a T9 compression fracture after a trivial injury. We started to control the pain with epidural steroid injections and epidural patient controlled analgesia (PCA). The patient got new fractures at T8 and L2, even though on bed rest. No evidence of metabolic bone disease or malignancy was noted on routine laboratory tests. Increased uptake of radioactivity at multiple vertebrae was shown on bone scan and the magnetic resonance imaging (MRI) finding was suspected to be an infiltrative bone marrow disease.
Therefore, we consulted an oncologist for further evaluation, then the patient was diagnosed with multiple myeloma with bone marrow biopsy. This case report suggests that clinicians should consider the possibility of malignancy in the case of multiple compression fractures of vertebrae especially in young male patients. |
| Key Words:
Backpain; myeloma; vertebral fracture |
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