Skeletal manifestations and role of dexa study in 32 patients with multiple myeloma

ABSTRACT

To discuss skeletal manifestation of patients with multiple myeloma and the role of double energy X-ray photometry study in the management of those patients. 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 and physical examination including Age, Sex, Bone pain, pathological fracture, Localized tenderness and Bone swelling. Pathological fracture found in [14] [43.75%], [10] were males [50%] of total males and [4] were females [33.3%] of total females.Serum Alkaline Phosphatase ranging between [30-135KAU/L], mean [75.218KAU/L], patients who got serum alkaline phosphatase level>80 KAU/L are[13][40.62%],[1 lX84.6%] of them got localized tenderness and [11] [84.6%] of them got pathological fracture, but those who got serum alkaline phosphatase >100 KAU/IL all of them got pathological fracture. DEXA study found to be significant in [24] [75%] and 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, [1 7X80.9%] with a positive spine X-ray,[10] [71.42%] with apositive pelvic X-ray and [8] [80%] with apositive longe bone X-ray. Significant DEXA found in [11] [91.66%] patients with S.Calcium >2.6mmol/L and those who got S.Calciuin >3.3 mmol/Lall got significant DEXA. The most common presenting feature is bone pain. Pathological fractures were more common in males than females, all patients with serum alkaline phosphatase > 100KAU/L got pathological fractures and there is no relationship between localized tenderness and 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 and needed close observations and treatment to improve bone T condition