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March 14, 1980

Flail Chest and Multiple Myeloma

Author Affiliations

Little Rock Veterans Administration Medical Center Little Rock, Ark

JAMA. 1980;243(10):1036. doi:10.1001/jama.1980.03300360012008

To the Editor.—  Multiple myeloma is a common disease that universally involves the skeletal system. Although rib lesions are common, flail chest resulting from multiple rib fractures or disarticulation is extremely rare. The occurrence of such a complication in a patient with multiple myeloma prompted this report and a review of the literature of the past 20 years.

Report of a Case.—  A 54-year-old man was admitted to the hospital because of low back pain of four months' duration. Diagnosis of multiple myeloma was established on the basis of multiple lytic bone lesions and bone marrow plasmacytosis (80% of the nucleated cells) associated with hypercalcemia. He was transferred to Little Rock Veterans Administration Medical Center for treatment.On arrival he had dyspnea secondary to flail chest resulting from spontaneous disarticulation of several ribs from the sternum. The rest of the findings from the physical examination were within the normal range.