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A previously healthy 54-year-old woman presented with a two-week history of pelvic pain. On physical examination, she had limited movement, without tenderness in the bones. An initial radiographic survey of skeletal bone showed multiple lytic lesions in the axial skeleton (Panel A, arrow), the ribs, the skull (Panel B, arrow), bilaterally in the pelvis, both femurs (Panel C, arrow), and both humeri (Panel D, arrow). Blood tests showed normocytic normochromic anemia with a hematocrit of 24.9 percent, along with a sedimentation rate of 140 mm per hour. Calcium levels and the results of kidney-function and liver-function tests were normal. The . . . [Full Text of this Article] |