[Bone scintigraphy in multiple myeloma].

The results of bone scintigraphy were compared with those of plain skeletal X-rays in 26 patients with multiple myeloma who all presented radiological and/or scintigraphic skeletal lesions. 364 bone sites were studied: 135 of them were abnormal, 64 on the plain X-ray alone, 21 on scintigraphy alone and 50 on both examinations. The sensitivity of the bone scintigraphy was only greater than that of plain X-rays for the thoracic lesions (sternum and ribs). The skeletal lesions detected by scintigraphy in addition to those detected on the X-ray would have changed the clinical staging of the patient in only 3 cases. Purely lytic lesions of the thoraco-lumbar spine were never detected by bone scintigraphy. More than one third of the compression fractures were also missed by this examination. The radiological course of 13 sites initially abnormal only on the bone scintigraphy was followed for 6 to 24 months; after this period of time, 9 of these lesions were still radiologically normal. In 6 patients, the radiographic and scintigraphic course could be compared to the clinical and laboratory data on 14 occasions: both pain X-rays and scintigraphy were only concordant with the clinical and laboratory course in no more than one half of cases. The number of abnormal sites on scintigraphy was no different in the patients who responded to treatment. In multiple myeloma, bone scintigraphy only detects a little more than half of the skeletal lesions. When performed in addition to plain X-rays, it detects about 16 per cent of additional lesions, particularly in the ribs and sternum.(ABSTRACT TRUNCATED AT 250 WORDS)