I have polled a few, but curious if there are other thoughts.
Patient diagnosed with smoldering myeloma in 2015, stable since then. Lab
values are largely stable (M spike, H/H, Cr, IgG from 1860– > 2100 now).
2021 marrow screen negative
[image: image.png]
2022 lesion seen in left humerus. patient asymptomatic from this
T1
[image: image.png]
STIR
[image: image.png]
Came back for chemical shift imaging:
Out/In
[image: image.png]
Marked drop out well above the 20-30% threshold
STIR
[image: image.png]
On STIR, stands out to the background of red red marrow seen in the
acromion and clavicle with similar signal intensity to the OA changes on
glenoid.
I know myeloma can be tricky. Any thoughts on this? Red
marrow/tumor/something else?
Thanks,
Adam
