A man with a fracture from minor trauma

Area of Science:

• Orthopedics
• Oncology
• Hematology

Background:

• Fractures commonly result from trauma, but pathological fractures due to underlying diseases require different management.
• Atypical presentations of fractures warrant thorough investigation for underlying pathologies.
• Early recognition of subtle symptoms is vital for effective treatment of pathological fractures.

Purpose of the Study:

• To highlight the importance of considering multiple myeloma in cases of atypical fractures.
• To emphasize the diagnostic and therapeutic challenges in managing pathological fractures.
• To underscore the need for vigilance in emergency practice for potentially serious underlying conditions.

Main Methods:

• A case report detailing a patient with a left clavicle fracture secondary to minor trauma.
• Initial X-ray revealed a suspicious lesion, leading to further investigation.
• Diagnosis of multiple myeloma was confirmed, followed by VTD induction therapy, high-dose melphalan, and autologous stem cell transplant.

Main Results:

• The patient was diagnosed with multiple myeloma after presenting with a clavicle fracture.
• Treatment involved induction chemotherapy, stem cell transplant, and maintenance therapy.
• The patient is currently symptom-free and on maintenance thalidomide.

Conclusions:

• Multiple myeloma, though uncommon in emergency settings, can present as a pathological fracture.
• Early detection of subtle symptoms associated with multiple myeloma is critical for timely intervention.
• Delayed diagnosis can lead to severe consequences; heightened awareness is necessary.