Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
AIM OF THE STUDY :
To discuss skeletal manifestation of patients with multiple myeloma &the role of double energy X-ray photometry study in the management of those patients .
PATIENTS & METHODS:
During period from the 1st of April 2004 to 1st of January 2005 we collected 32 patients who fulfilled the criteria of diagnosis of multiple myeloma. .All our patients have detailed history & physical examination including: Age, Sex, Bone pain, pathological fracture, Localized tenderness & Bone swelling
RESULTS:
Pathological fracture found in (14) (43.75%), (10) were males (50%) of total males & (4) were females (33.3%) of total females.Serum Alkaline Phosphatase ranging between (30-135KAUL), mean (75.218KAUL), patients who got serum alkaline phosphatase level>80 KAUL are(13)(40.62%),(11)(84.6%) of them got localized tenderness &(11) (84.6%) of them got pathological fracture ,but those who got serum alkaline phosphatase >100KAU|L all of them got pathological fracture. DEXA study found to be significant in (24) (75%) & insignificant in (8) (25%).All the studied patients with pathological fracture got significant DEXA.
Significant DEXA found in (12) (75%) of patients with positive skull X-ray, (17)(80.9%) with a positive spine X-ray,(10) (71.42%) with apositive pelvic X-ray &(8) (80%) with apositive longe bone X-ray. Significant DEXA found in (11) (91.66%) patients with S.Calcium >2.6mmolL & those who got S.Calcium >3.3 mmolLall got significant DEXA.
DISCUSSION & CONCLUSIONS:
The most common presenting feature is bone pain.
Pathological fractures were more common in males than females, all patients with serum alkaline phosphatase >100KAUL got pathological fractures & there is no relationship between localized tenderness &pathological fracture. here is no patient with pathological fracture with insignificant DEXA. The more advanced changes in DEXA study had higher risk of pathological fracture & needed close observations &treatment to improve bone
T condition.