title: Infection--an underappreciated cause of bone pain in multiple myeloma.
abstract: Bone pain, especially back pain, is a common presenting feature of myeloma patients. We report three multiple myeloma patients with exacerbations of back pain and referred shoulder pain resulting from vertebral infections. Two patients were treated with surgery, and one patient had computerized tomography-guided percutaneous needle aspiration for diagnostic purposes. All three patients received a prolonged course of antibiotics. Vertebral infection resolved with this treatment in all three patients without any recurrence. Previous dexamethasone therapy, together with an episode of bacteraemia, appears to be a predisposing factor for vertebral infection. Magnetic resonance imaging enabled the diagnosis in all three patients.
authors.affiliation: Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Raman
authors.initials: R
authors.lastname: Desikan
authors.forename: Bart
authors.initials: B
authors.lastname: Barlogie
authors.forename: Rajesh
authors.initials: R
authors.lastname: Sethi
authors.forename: Amir
authors.initials: A
authors.lastname: Toor
authors.forename: Dan
authors.initials: D
authors.lastname: Spoon
authors.forename: Edward
authors.initials: E
authors.lastname: Angtuaco
authors.forename: Rudy
authors.initials: R
authors.lastname: Vanhemert
authors.forename: Anantha
authors.initials: A
authors.lastname: VijayaGopal
authors.forename: Seema
authors.initials: S
authors.lastname: Singhal
authors.forename: Jayesh
authors.initials: J
authors.lastname: Mehta
authors.forename: Sundar
authors.initials: S
authors.lastname: Jagannath
authors.forename: Nikhil
authors.initials: N
authors.lastname: Munshi
authors.forename: Maurizio
authors.initials: M
authors.lastname: Zangari
authors.forename: Athanassios
authors.initials: A
authors.lastname: Fassas
authors.forename: Guido
authors.initials: G
authors.lastname: Tricot
authors.forename: Elias
authors.initials: E
authors.lastname: Anaissie
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001416:Back Pain / Q000175:diagnosis / Q000209:etiology; D015299:Discitis / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D010146:Pain / Q000188:drug therapy / Q000209:etiology*; D013203:Staphylococcal Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents