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Lesion in pubic ramus, scan report normal, bone marrow analysis suggestion - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Bones, Muscles and Joints
Answered by

General & Family Physician
Practicing since : 2004
Answered : 1722 Questions
Doctor :   Hi
User :   hi
Doctor :   How can I help you?
User :   what kind of dr are u please?
Doctor :   I am a general physician.
User :   are u familiar with Multiple myeloma
Doctor :   Yes.
User :   ok. I have a lesion in My pubic ramus that was diagnosed via MRI
User :   it was non specific
Doctor :   Ok
User :   the radiologist stated in the report that it could be a hemangioma or enchondroma but a metestic cancer could not be rued out by the mri only a bone scan is recommended if clinically indiated
User :   so I went for a bone scan which was perfectly normal
Doctor :   Ok
User :   I had bloodwork 5 weeks ago before all this started and everything was normal no anemia etc
Doctor :   Ok
User :   The same day i had the mri on my pelvis i hada mri on my lumbar as well..which was unremarkable
Doctor :   Ok
User :   My family dr who I know very well said that I did not need any more testing.
Doctor :   Ok
User :   But I went to see a ortho oncologist just to see what he said
User :   the ortho onclogist looked at my scans and said he did not think it is cancer but wants me to get a spep test just to make sure even though he is 99 pct sure its not myeloma.
User :   he also recommends a ct scan with dye.
User :   in your opinion how likely would a single lesion in the pubic ramus be a myeloma?
Doctor :   Bone scan is usually very effective in picking up cancerous bone lesions.
User :   I read online that it does not pickup myeloma?
Doctor :   Since the bone scan has come negative, the chance that it could be one is very unlikely.
Doctor :   Yes, the definitive test is a bone marrow analysis. But considering all other findings which are against the features of multiple myleoma,
Doctor :   personally the chance that this could be related to
Doctor :   it is less than 2
Doctor :   *1% I mean.
User :   I also went throw me old blood test and realized I had a spep test in 2009 about 20 months ago would that matter it was normal
User :   I do have some muscle/bone pain but i Do excercise..
User :   lift weights etc
Doctor :   It would be better, if you can answer why hip bone scan was performed in the first instance.
Doctor :   I would be able to answer, your second question better, if you could provide this information?
User :   I had a pain in the oppisite hip and a tear of the labrum was found the lesion was incidental
Doctor :   Did you have this pain in Sept 2009 when you had the protein electrophoresis test done?
User :   I was not excercising back then the pain I have now comes and goes it not steady..sometimes just like a sharp ach that comes and goes
User :   i had shoulder surgery back then so I dont really remember the pain i get now is not diffrent from what I have felt in the past
User :   I have had numerous blood test over the last 2 yrs and my hemoglubin wbc rbc etc have all been the same for yrs
Doctor :   It is not clear since how long you had this lesion on the hips,
Doctor :   SPEP test done almost 2 years ago, has no
Doctor :   clinical relevance now.
Doctor :   as far as ruling out Mutiple myleoma now.
Doctor :   However
Doctor :   I do not suggest you to be concerned.
Doctor :   All your other symptoms, including normal blood work up all through since 2 years
Doctor :   are against the feature of multiple myeloma.
Doctor :   It would be very, very unlikely that unusually features could pop up on SPEP test now.
Doctor :   You may consider the tests as suggested by the oncologist to clear any suspicion which the doctor or perhaps you too have beyond doubts.
Doctor :   Do you follow what I have suggested?
User :   yes and ty
Doctor :   It seems that you have moved out of the chat window. Please login again if you have any other query.

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