Multiple Myeloma
A haematologic malignancy involving clonal proliferation of plasma cells, often affecting multiple skeletal sites.
Multiple myeloma is a plasma cell dyscrasia characterised by clonal proliferation of malignant plasma cells within the bone marrow. It commonly presents in patients over 60 with bone pain, fatigue, or pathological fractures.
Skeletal involvement is frequent, especially in the spine, ribs, pelvis, and skull, where lytic lesions or diffuse osteopenia are observed on imaging.
Laboratory findings may reveal anaemia, hypercalcaemia, renal impairment, and elevated serum/urine monoclonal proteins (M-protein). Diagnosis is confirmed via bone marrow biopsy and serum electrophoresis.
Treatment includes systemic therapy (e.g. bortezomib, lenalidomide, dexamethasone), bisphosphonates for bone disease, and supportive care. Radiation may be used for painful lesions or spinal cord compression.
Orthopaedic involvement focuses on fracture stabilisation and decompression where indicated.
