Ömer Esmez
Journal of Emergency Medicine Case Reports - 2025;16(4):147-149
Sternal fractures are typically associated with high-energy blunt trauma; however, spontaneous occurrence is rare and often under diagnosed. Multiple myeloma (MM) is a hematologic malignancy characterized by osteolytic lesions, increasing the risk of pathological fractures in flat bones. A 55-year-old male with an 8-year history of multiple myeloma, previously treated with autologous stem cell transplantation, presented with anterior chest pain without trauma. Laboratory tests showed normocytic anemia, thrombocytopenia, mild renal impairment, and elevated CRP . Initial thoracic CT was normal; however, follow-up imaging revealed progressive sternal osteolysis with a displaced fracture. Orthopedic consultation for interscapular pain radiating to the chest confirmed no additional pathology. The patient was hemodynamically stable and managed conservatively with analgesia, rest, and activity modification, while continuing myeloma-directed therapy. In MM patients presenting with new-onset chest pain without a trauma history, spontaneous pathological fracture should be considered. Early diagnosis is essential to avoid unnecessary invasive procedures and to guide appropriate treatment planning.
