A 67-year-old woman with no known primary malignancy, complained of generalized bone pain for 3 months. She appeared pale on physical examination with tenderness on deep palpation over the lumbar spine. Examination of other systems was unremarkable.
Laboratory investigations revealed normochromic normocytic anaemia and raised ESR. Serum electrophoresis demonstrated the presence of abnormal M-paraprotein. In view of the laboratory results, a blood dyscrasia was suspected and radiographs of the skull, ribs and femur were performed.
What abnormalities do you see on these selected radiographs and what is the diagnosis ?
