60F with fatigue and decreased alertness.  What is the diagnosis?


Multiple Myleoma:  Note lytic bone lesions of Skull.  (An easier find in Bone window).

Differential DX for lytic bone lesions:


  • Fibrous Dysplasia
  • Osteoblastoma
  • Giant Cell Tumor
  • Metastasis / Myeloma Myeloma
  • Aneurysmal Bone Cyst
  • Chondroblastoma / Chondromyxoid Fibroma
  • Hyperparathyroidism (brown tumors) / Hemangioma
  • Infection
  • Non-ossifying Fibroma
  • Eosinophilic Granuloma / Enchondroma
  • Solitary Bone Cyst


Brigham and Womens RAD Teaching Case Database http://brighamrad.harvard.edu/education/online/tcd/tcd.html