Congrats on your Hubby's Osteoclasts / blasts working over time.
I guess my question is more anatomical---why does your hubby have such a pronounced Pelvic
Tilt ? Is he full weight bearing yet ?
Did he have a Plasmacytoma " bony Collapse" on the right sided Superior aspect of the Acetablum or was this all pre-cancer ?
His right acetablum / femoral head is easily 1-1/2--2 inches higher than on the left. Even adjusting for the illiac crest dip.( Positioning)
His Pubis symphis is also "separated and rotated" fairly prominently--despite the spine being fairly well aligned in both films and he was positioned nearly identically.
The films ( transferred to this site) don't lend themselves well to appreciating "healed Lesions"--so I' ll pass on the rest. Then again, I have tired eyes. But It indeed looks filled in. Amazing stuff.
Glad he is doing well.
Forums
Re: Bone pain, bone healing, and treatment?
Dear LisaE,
Even taking into account some differences between the 2 images technically, the improvement is remarkable. We, too, have had patients who have responded well to therapy in whom the "holes," or lytic bone lesions, become less conspicuous over time (although they are typically still visible). However, for those of you who have not had visible change in your bone lesions despite a good response to treatment, that does not mean that healing has not occurred at some level. With successful treatment (realize that Revlimid can inhibit the osteoclasts that break down bone, while Velcade can augment the effects of the osteoblasts that build up bone, independent of their activity against the myeloma itself) and bisphosphonate therapy (Zometa, Aredia, etc), bone pain improves and the risk of future fractures diminishes. How could pain get better and the risk of fractures decrease if bone healing was not occurring?
Also, it is important to note that a persistent bone lesion seen on x-ray does not equate to persistent, active myeloma at that site (as Dr. Kaufmann pointed out earlier). It just means that there are persistent changes in bone. It would be interesting to know why some patients have more robust filling in of these lytic bone lesions than others (like LisaE's husband) and if that translates into an even further reduction in the risk of fractures and pain in these patients.
LisaE, thanks for sharing and best wishes to your husband – may he continue on the road to recovery!
Pete V.
Even taking into account some differences between the 2 images technically, the improvement is remarkable. We, too, have had patients who have responded well to therapy in whom the "holes," or lytic bone lesions, become less conspicuous over time (although they are typically still visible). However, for those of you who have not had visible change in your bone lesions despite a good response to treatment, that does not mean that healing has not occurred at some level. With successful treatment (realize that Revlimid can inhibit the osteoclasts that break down bone, while Velcade can augment the effects of the osteoblasts that build up bone, independent of their activity against the myeloma itself) and bisphosphonate therapy (Zometa, Aredia, etc), bone pain improves and the risk of future fractures diminishes. How could pain get better and the risk of fractures decrease if bone healing was not occurring?
Also, it is important to note that a persistent bone lesion seen on x-ray does not equate to persistent, active myeloma at that site (as Dr. Kaufmann pointed out earlier). It just means that there are persistent changes in bone. It would be interesting to know why some patients have more robust filling in of these lytic bone lesions than others (like LisaE's husband) and if that translates into an even further reduction in the risk of fractures and pain in these patients.
LisaE, thanks for sharing and best wishes to your husband – may he continue on the road to recovery!
Pete V.
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Dr. Peter Voorhees - Name: Peter Voorhees, M.D.
Beacon Medical Advisor
Re: Bone pain, bone healing, and treatment?
I had a full body x-ray and MRI and both showed no lesions. Then I had a PET scan and it showed many lesions. So guess I needed only a PET scan and glad my doctor kept up the testing. 
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aseidel - Name: Anne
- Who do you know with myeloma?: Self
- When were you/they diagnosed?: October 2015 with plasmacytoma
- Age at diagnosis: 58
23 posts
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