title: A man with a fracture from minor trauma.
abstract: BACKGROUND
  We commonly encounter fractures secondary to trauma on and off in our daily practice. While it is not uncommon to see fractures due to underlying pathology, we need to be on the alert when patients present atypically because the treatment for pathological fractures is far different from that for simple fractures.
  
  
  METHODS
  We presented a case of left clavicle fracture secondary to minor trauma, in which the initial X-ray shows suspicious lesion around the fracture site and further investigation reveals multiple myeloma. The patient received treatment at the clinical oncology department upon diagnosis. Since he was relatively young and fit, he was started on the induction therapy of VTD, which was followed by high dose melphalan and autologous stem cell transplant.
  
  
  RESULTS
  He is currently free from symptoms and on maintenance thalidomide.
  
  
  CONCLUSIONS
  Though multiple myeloma is not commonly encountered in emergency practice, earlier identification of relatively subtle symptoms can allow early treatment. Missing this diagnosis will delay treatment and produce severe outcome to the patient. We should be on the alert for such important condition.
authors.affiliation: Kwong Wah Hospital, Accident and Emergency Department, Kowloon, Hong Kong, China.
authors.forename: Siu Ming
authors.initials: SM
authors.lastname: Yang
authors.affiliation: Kwong Wah Hospital, Accident and Emergency Department, Kowloon, Hong Kong, China.
authors.forename: Chor Man
authors.initials: CM
authors.lastname: Lo
keywords: Multiple myeloma; Neoplasm metastasis; Spontaneous fracture