Plasma Cell Myeloma : Pathologic Fracture

Comments:
One of the diagnostic hallmarks of plasma cell myeloma is lytic bone lesions which increase the risk of pathologic fractures. This plain radiograph is from 65 y/o male with a known history of plasma cell myeloma who presented with right hip pain. Patient reported hearing a crack before the onset of pain. The radiograph shows right subtrochanteric pathologic fracture. Surrounding the fracture is a lytic lesion, which had been previously demonstrated as a myelomatous deposit.

Pathological fracture refers to a fracture through an area of underlying abnormal bone. Although in the vast majority of cases there is an underlying malignant lesion, such as a metastasis or myelomatous deposit, this need not always be the case. Pathological fractures are a common complication of plasma cell myeloma. Case courtesy of Dr Henry Knipe, Radiopaedia.org. From the case rID: 25272