Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Radiol. Dec 28, 2019; 11(12): 144-148
Published online Dec 28, 2019. doi: 10.4329/wjr.v11.i12.144
Chest pain without a clue-ultrasound to rescue occult multiple myeloma: A case report
Gopal Chawla, Naveen Dutt, Kunal Deokar, Virender Kumar Meena
Gopal Chawla, Naveen Dutt, Kunal Deokar, Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, Jodhpur 342008, Rajasthan, India
Virender Kumar Meena, Department of Radiodiagnosis, Geetanjali Medical College and Hospital, Udaipur 342005, India
Author contributions: All authors conceived the idea; Chawla G, Deokar K, Meena VK collected the data; Chawla G, and Dutt N performed the literature search; Chawla G, and Deokar K wrote the manuscript; Deokar K, Dutt N, Meena VK critically reviewed the manuscript.
Informed consent statement: Informed consent was obtained from the patient.
Conflict-of-interest statement: The authors state they have no conflicts of interest.
CARE Checklist (2016) statement: Guidelines of the CARE checklist (2016) have been adopted.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Gopal Chawla, DNB, FCCP, MBBS, MD, Academic Fellow, DM Fellow, Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, Jodhpur 342005, Rajasthan, India. dr.gopalchawla@gmail.com
Telephone: +91-7982283553
Received: July 3, 2019
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
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

Ultrasound of bone can often aid in reaching a diagnosis indirectly if not directly.

Keywords: Case report, Ultrasound, Multiple myeloma, Chest pain

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.