Published online Dec 28, 2019. doi: 10.4329/wjr.v11.i12.144
Peer-review started: July 16, 2019
First decision: September 21, 2019
Revised: October 11, 2019
Accepted: November 7, 2019
Article in press: November 7, 2019
Published online: December 28, 2019
Chest pain is one of the most common symptoms with which a patient presents to a doctor. Differentials include, but are not limited to, cardiac pulmonary, gastrointestinal, psychosomatic and musculoskeletal causes. In our case, ultrasound of the chest wall paved the way for the diagnosis of multiple myeloma, which occultly presented with chronic chest pain.
Here we report a case of 50-year-old man with chronic chest pain without anemia or renal failure who was diagnosed with multiple myeloma, despite negative bence jones protein and M band electrophoresis. An ultrasound of the chest wall showed cortical irregularities along with a hypoechoic mass in the sternum and left 5th rib, which helped us in clinching the diagnosis.
Ultrasound of bone can often aid in reaching a diagnosis indirectly if not directly.
Core tip: Multiple myeloma is notorious for presenting in atypical ways, and one should have a high index of suspicion for the same. Ultrasounds of bone can often aid in reaching a diagnosis indirectly if not directly.