Mr. Brown has many pulmonary, ganglionic and bone lesions that are very painful and partially responsive to analgesic treatment.
Skeletal involvement is mostly located in small bone, showing many lytic lesions; less frequently, bone lesions have a sclerotic appearance.
Severe bone pain is a frequent presenting symptom, and is a hallmark of lytic bone lesions, which in many patients results in long bone and/or vertebral compression fractures.
However, excess fluoride in drinking water results in many bone diseases, including mottling of teeth and lesions of the endocrine glands, thyroid, liver and other organs (Tang et al. 2009).
In MM, bone lesions are due to the secretion of many cytokines by plasma cells, bone marrow stromal cells, osteoblasts and osteoclasts, leading to an uncoupling of bone remodeling with increased bone resorption contrasting with a reduction in bone formation.
Besides many advantages of the described techniques, determining history and activity status of bone lesions in multiple myeloma cannot be assessed.
In many respects, the disease is reminiscent of chronic osteomyelitis, fibrous dysplasia, osteosarcoma, benign cystic bone lesions, lesions caused by hyperparathyroid tumors and other neoplastic lesions [ 5].
While the utility of CT scanning is limited to detection of destructive bone lesions, PET is able to detect involvement of bone or bone marrow in many cases [ 16– 16].
17 MRI has been proven in many studies to be more accurate than plain x-ray or CT scan in detecting myeloma bone lesions with a higher sensitivity.
Our objective was to review the computed tomography (CT) appearances of bone lesions detected on positron emission tomography (PET)/CT images, and to assess our initial experience of how many PET detected bone lesions were visible on our CT images.
