In multiple myeloma, which imaging finding is commonly seen?

• A. Sclerotic lesions
• B. Lytic bone lesions
• C. Osteophyte formation
• D. Epiphyseal plate widening

Answer: (B)

Multiple myeloma destructive bone lesions are due to malignant plasma cells stimulating osteoclasts and inhibiting osteoblasts, leading to focal bone loss. The classic imaging finding is lytic, “punched-out” lesions, often seen in the skull, spine, pelvis, and ribs, and these lesions can combine with generalized osteopenia and an increased risk of pathologic fractures.

Sclerotic lesions would point toward conditions that form new bone, such as osteoblastic metastases (e.g., from prostate cancer) or Paget disease, not typical myeloma. Osteophyte formation reflects degenerative joint disease, not myeloma-related bone destruction. Epiphyseal plate widening is seen in growing children or certain metabolic conditions, not in adult multiple myeloma.