Attending Version: Back Pain Emergencies Module; created by Dr. Wendy Gerstein


What is the best way to further evaluate the cause of this fracture?



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What is the best way to further evaluate the cause of this fracture?
Patient underwent CT guided biopsy, which revealed plasmacytoma. Skeletal survey was otherwise negative, as were MRIs of entire spine. SPEP revealed a paraprotein spike – IgG Kappa. Patient was given a diagnosis of solitary plasmocytoma.
Treatment?
Orthopedics consulted – no spine instability, recommended TLSO brace. Heme-onc consulted, recommended 4 weeks of radiation and close follow up as many of these patients will ultimately develop multiple myeloma.



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