Twenty seven patients with multiple myeloma admitted to the Severance Hospital,
Yonsei University College of Medicine between January 1980 and June 1985 were
studied, and the results obtained were as follow :
1. The age distribution was between 19 and 75 with median age of 56 years. The
peak incidence was 6th decades. Male to female ratio was 1.3 : 1.
2. The most frequent clinical symptom was bone and joint pain, 67% of the cases.
3. The anemia was Present in all cased(100%), hypercalcemia in 29%, increased
creatinine in 56%, and increased alkaline phosphatase in 50%.
4. Clinical stage were Stage Ⅰ in 7.3%, Stage Ⅱ in 22.2%, and Stage Ⅲ in 70.5%;
stage A 44.3% and stage B in 55.7%.
5. More than 1 bone lesion were detected in 96% on plain bone X-ray and in 85% on
whole body bone scanning,
6. The same number of bone lesions on both examinations were noted in 7(26%) :
and more lesions on plain K-ray in 19(71%), and more lesions on bone scan in only 1
(3%).
7. Among 7 cases with same number of lesions, 4 sites matching was in 1, 3 sites
matching in 2, 2 sites matching in 2, and 1 site matching in 2 cases.
8. With total number of bone involvements in 7 bone system: the frequent site of
involvement were rib(74%), skull(74%), spine(71%), pelvis(22%), clavicle(7%), and
scapula(7%) in order on plain bone X-ray(69 lesions) with mean of 2.6 per case; while
rib(78%), spine(41.8), skull (30%) Pelvis(11%), and clavicle(7%) in order on bone scan(45
lesions) with moan of 1.7 per case.
The detection rate of bone involvement was 36. 5% on plain bone X-ray and 23.8%
on bone scan; the comparative detection rate of bone scan to plain bone X-ray was
65.2% which was higher than for eight reports.
9. The mean of lesion3 was 3. 1 on plain X-ray and 2. 1 on bone scan in
hypercalcemic group with decreased calcium level.
10. Serum alkaline phosphatase was increased in 12 cases with mean of lesson 2.8 on
plain X-ray and 1. 8 on bone scan.
11. There was neither relationship between the types of M-components nor levels of
M-components and number of bone lesions.
With above results, plain bone X-ray was superior to the bone scan in the detection
of bone lesions in clinical multiple myeloma. The higher detection rate of bone scan in
this country than foreign reports, may be attributed to the more advandd disease states,
tut needs further studies for definite conclusion.
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