Belchos Melissa, Kumar Varsha, Weis Carol Ann
Division of Graduate Studies, Canadian Memorial Chiropractic College.
Private practice.
J Can Chiropr Assoc. 2020 Dec;64(3):237-247.
Kappa (κ) light chain multiple myeloma can be disguised as low back pain (LBP), and as such may present to a primary contact provider such as a chiropractor. The rarity and non-specific nature of the clinical presentation of this condition typically lead to a delayed diagnosis.
A 53-year old male avid golfer presented to a chiropractor with a chief complaint of LBP. He was diagnosed with sacroiliac joint dysfunction. His pain was initially improving with chiropractic management. The character of his pain changed, and the chiropractor referred for further imaging. He was subsequently diagnosed with κ light chain multiple myeloma.
This case presentation highlights that spinal malignancy is a possible cause of LBP. It reminds the clinician to investigate signs and symptoms that could lead to a suspicion of malignancy, to monitor patient progression, and consider further evaluations if the expected response to treatment is not achieved.
κ轻链多发性骨髓瘤可能被伪装成腰痛（LBP），因此可能会就诊于诸如脊椎按摩师等初级接触医疗服务提供者。这种疾病临床表现的罕见性和非特异性通常会导致诊断延迟。
一名53岁热爱高尔夫的男性因主要诉求为腰痛就诊于一名脊椎按摩师。他被诊断为骶髂关节功能障碍。最初，通过脊椎按摩治疗他的疼痛有所改善。后来他疼痛的性质发生了变化，脊椎按摩师安排了进一步的影像学检查。随后他被诊断为κ轻链多发性骨髓瘤。
该病例报告强调脊柱恶性肿瘤是腰痛的一个可能原因。它提醒临床医生要对可能导致怀疑恶性肿瘤的体征和症状进行调查，监测患者的病情进展，并在未达到预期治疗反应时考虑进一步评估。
