Puncture-like changes in skull destruction

Introduction X-ray examination of multiple myeloma showed multiple osteolytic osteoid-like bone defects or osteoporosis and pathological fractures.

Cause

Seen in the bone destruction type of multiple myeloma.

an examination

X-ray positive lateral slice shows: the skull and facial bone can be seen in multiple spots of different sizes, worm-like, wearing a bone-like destruction zone, the edge of the lesion is smooth, no hardened edge, no periosteal reaction.

The main reasons for diagnosis are: M protein peaks appearing in serum protein electrophoresis; bone X-ray examination shows multiple osteolytic changes; a large number of myeloma cells are found in bone marrow smears. If two of the three are positive, combined with clinical manifestations, a diagnosis can be made.

Differential diagnosis

Continuous cranial interruption: traumatic continuous cranial interruption is most common in skull fractures, which can be concave fractures, linear fractures, and cranial suture separation.

Skull lesions: Bone lesions are found in almost all Langerhans cell histiocytosis patients. Individual bone lesions have more bone lesions, mainly manifested as osteolytic lesions. Skull lesions are most common, followed by lower extremity bones, ribs, pelvis and spine, and jaw lesions are also quite common.

Skull fracture: The skull is a spherical shell that accommodates and protects the contents of the skull. The importance of skull fractures is not in the skull fracture itself, but in the concurrent damage of the cranial cavity. According to the shape of the fracture, it is classified into: linear fracture, depressed fracture, comminuted fracture, and child growth fracture. A fractured piece of a depressed or comminuted fracture can damage the meninges and brain and damage the cerebral blood vessels and cranial nerves. Skull fractures account for about 15-20% of craniocerebral injury, which can occur in any part of the skull, with the largest amount of parietal bone, followed by the frontal bone, followed by the humerus and occipital bone. Generally, the fracture line does not cross the cranial suture. If the violence is too large, it can also affect the adjacent bone. The positive lateral position of the skull can be diagnosed. Because of the different fracture morphology, the treatment and prognosis are also different.

Huge skull defects: Most of the skull defects are caused by open craniocerebral injury or firearm penetrating injury. Some patients have residual bone defects due to surgical decompression or diseased skull resection. In recent years, due to the high brain pressure of severe craniocerebral injury, the decompressive method of decompressive craniectomy is prevalent, so there are many artificial large skull defects. In fact, a considerable number of patients do not need large cranial decompression. Most of them are decisions made during the surgery, and there are no defects.

X-ray positive lateral slice shows: the skull and facial bone can be seen in multiple spots of different sizes, worm-like, wearing a bone-like destruction zone, the edge of the lesion is smooth, no hardened edge, no periosteal reaction. The main reasons for diagnosis are: M protein peaks appearing in serum protein electrophoresis; bone X-ray examination shows multiple osteolytic changes; a large number of myeloma cells are found in bone marrow smears. If two of the three are positive, combined with clinical manifestations, a diagnosis can be made.

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