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Suffering from hip pain, MRI shows tear, does Myeloma present a lesion ?

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Answered by

Orthopaedic Surgeon
Practicing since : 2005
Answered : 43 Questions
Hi Dr,
I had a MRI of my pelvic and lumbar area after suffering from hip pain. The MRI found a tear in the hip with pain, but incidentally found a non specific 1.7 cm lesion in My inferior Ramus. The radiologist stated that this could represent a hemangioma, enchodroma but a metestic disease could not be ruled out based on exam alone. So I went for a bone scan which was unremarkable. My family Dr said no more testing necassary since I had blood work 5 weeks earlier in which all My numbers RBC,WBC, HEMO, HMCT, ALBIUM 5.1(H) CREATINE were normal. I then felt like I would just speak to one more Dr. so I went to see a Ortho Oncologist, who reviewed My films. The Dr said "I dont think its a cancer or a enchodroma. But wants me just to get a SPEP test to rule out a Myleoma", he went on to say he was 99 pct sure it was not. He also wants a Ct scan with XXXXXXX Now I am VERY WORRIED. I was looking over some old blood work and I found I had a SPEP test in 2009 which was perfectly normal...I am 42 male. My lumbar spine was unremarkable. I had a chest xray in XXXXXXX that as normal as well. Would Myeloma present with one lesion??? would My bloodwork be all good??? would the SPEP even though awhile ago have shown something??( dont think MM just pops up) How long does it take for these lesions to grow??? and lastly can't a radiologist tell the diff between lesions..I mean he did not mention myeloma or anything with my bone marrow..advice opinion??? I do have some discomfort in the buttocks but I do lift weights.
Wed, 23 May 2012 in Blood Cancer(Leukemia)
Answered by Dr. Sangeet 3 hours later
Hello Lcamello,

With respect to your MRI findings, its difficult to state whether its a benign or malignant lesion. Multiple myeloma can be multiple or singly present as a Plasmacytoma, however blood and urine tests have to rule it out.

Urine Bence XXXXXXX proteins, Serum immunoelectrophoresis and a radiologist alone to comment on the diagnosis. He can only give differential diagnosis lest the tumor is very typical in appearance. Diagnosis of a tumor requires a triad of Radiologist, Pathologist and the operating Surgeon.

For a tumor to be visible on X-rays, it should have eaten up at least 30% pf your bone. This takes at least 6 weeks.

Please send me your MRI and Xray films @ YYYY@YYYY ATTN 'Sangeet'. If not done an Xray of the pelvis, better to go for one.

I could help you better if you send them to me. I will be available for further follow up.

Thank you.
Above answer was peer-reviewed by
Follow-up: Suffering from hip pain, MRI shows tear, does Myeloma present a lesion ? 14 hours later
I had a xray of my pelvic it was normal and I also had a MRI of my lumbar which was unremakable.
Answered by Dr. Sangeet 2 hours later

Thanks for writing back.

As I said, its difficult to comment without seeing X-rays or MRI.
To establish a diagnosis, I would suggest you to get the SPEP done, as it was done long time ago and if possible, send me the MRI film which shows the lesion.

Also follow up with the Orthopaedician if your pain has increased or developed at some other site.

Hope, I have answered all your queries. In case of further doubts, I will be available for follow up.
Above answer was peer-reviewed by
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