Skip to main content
SpringerLink
Log in

Upper humeral cortical thickness as an indicator of osteopenia: diagnostic significance in solitary myeloma of bone

  • Articles
  • Published:
Skeletal Radiology Aims and scope Submit manuscript

Abstract

Solitary myeloma of bone is a form of plasma cell tumor, histologically indistinguishable from multiple myeloma but characterised by a single bony focus of disease. Most patients respond to local radiotherapy (median survival 10–12 years); however, many (>30%) rapidly develop multiple myeloma (median survival 2–4 years). Currently, no criteria exist for identifying these high-risk patients at the time of diagnosis.

We have assessed the prognostic value of clinical features at presentation in 32 patients with solitary myeloma of bone. Only osteopenia at presentation (P<0.000003) and immunoparesis (P<0.00002) proved to be independent, significant prognosticators of decreased survival. Exclusion of patients with osteopenia or immunoparesis at presentation identified a group with an 80%–90% chance of surviving 10 years. Patients with either risk factor had a median survival of only 27 months.

Osteopenia was assessed using measurements of combined cortical thickness in the upper humerus. This site has not previously been used, and normal values are presented for a control group (n=413).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Alexanian R (1980) Localised and indolent myeloma. Blood 56:521

    PubMed  Google Scholar 

  2. Bataille R, Sany J (1981) Solitary myeloma; clinical and prognostic features of a review of 114 cases. Cancer 48:845

    PubMed  Google Scholar 

  3. Bertolini DR, Nedwin G, Bringman T (1986) Stimulation of bone resorption and stimulation of bone formation in vitro by human tumour necrosis factor. Nature 319:516

    PubMed  Google Scholar 

  4. Bloom RA (1980) A comparative estimation of the combined cortical thickness of various bone sites. Skeletal Radiol 5:167

    PubMed  Google Scholar 

  5. Bloom RA, Laws JW (1970) Humeral cortical thickness as an indicator of osteoporosis in women. Br J Radiol 43:522

    PubMed  Google Scholar 

  6. Bloom RA, Pogrund H, Libson E (1983) Radiogrammetry of the metacarpal: a critical reappraisal. Skeletal Radiol 10:5

    PubMed  Google Scholar 

  7. Christopherson WM, Miller AJ (1950) A re-evaluation of solitary plasma-cell myeloma of bone. Cancer 3:240

    Google Scholar 

  8. Chronic Leukaemia and Myeloma Task Force. National Cancer Institute (1973) Proposal guidelines for protocol studies II. Plasma cell myeloma. Cancer Chemother Rep 4(3): 145

    Google Scholar 

  9. Conklin R, Alexanian R (1975) Clinical classification of plasma cell myeloma. Arch Intern Med 135:139

    PubMed  Google Scholar 

  10. Corwin J, Lindberg RD (1979) Solitary plasmacytoma of bone vs. extramedullary plasmacytoma and their relationship to multiple myeloma. Cancer 43:1007

    PubMed  Google Scholar 

  11. Dequeker J (1976) Quantitative radiology: radiogrammetry of cortical bone. Br J Radiol 49:912

    PubMed  Google Scholar 

  12. Dewhurst FE, Stashenko PP, Mole JE (1985) Purification of partial sequences of human osteoclast activting factor: identity with interleukin 1 beta. J Immunol 135:2562

    PubMed  Google Scholar 

  13. Durie BGM (1986) Staging and kinetics of multiple myeloma. Semin Oncol 13(3): 300

    PubMed  Google Scholar 

  14. Durie BJM, Salmon SE (1975) A clinical staging system for multiple myeloma. Cancer 36:842

    PubMed  Google Scholar 

  15. Jacobson DR, Zolla-Pazner S (1986) Immunosuppression and infection in multiple myeloma. Semin Oncol 13(3): 282

    PubMed  Google Scholar 

  16. Josse RG, Murray TM, Mundy GR (1981) Observations on the mechanisms of bone resorption induced by multiple myeloma marrow culture fluids and partially purified osteoclast activating factor. J Clin Invest 67:1472

    PubMed  Google Scholar 

  17. Meema HE (1963) Cortical bone atrophy and osteoporosis as a manifestation of ageing. Am J Roentgen 89:1287

    Google Scholar 

  18. Mindy GR, Bertolini DR (1986) Bone destruction and hypercalcaemia in plasma cell myeloma. Semin Oncol 13(3):291

    PubMed  Google Scholar 

  19. Morgan DB (1973) The metacarpal bone: a comparison of the various indices for the assessment of the amount of bone and for the detection of bone loss. Clin Radiol 24:77

    PubMed  Google Scholar 

  20. Virtama P, Telkka A (1962) Cortical thickness as an estimate of mineral content of the human humerus and femur. Br J Radiol 35:632

    PubMed  Google Scholar 

  21. Wiltshaw E (1976) The natural history of extramedullary plasmacytoma and its relationship to solitary myeloma of bone and myelomatosis. Medicine 55:217

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Diagnostic Radiology, Stopford Medical School, University of Manchester, Manchester, UK

    Alan Jackson Ph.D., M.R.C.P., F.R.C.R.

  2. Cancer Research Campaign, Department of Medical Oncology, The Christie Hospital & Holt Radium Institute, Manchester, UK

    J. Howard Scarffe M.D., F.R.C.P.

Authors
  1. Alan Jackson Ph.D., M.R.C.P., F.R.C.R.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. Howard Scarffe M.D., F.R.C.P.
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Jackson, A., Scarffe, J.H. Upper humeral cortical thickness as an indicator of osteopenia: diagnostic significance in solitary myeloma of bone. Skeletal Radiol. 20, 363–367 (1991). https://doi.org/10.1007/BF01267664

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01267664

Key words

Search

Navigation