Running through the following diagnostic gamut of bone lesions, a correct diagnosis is usually made:
1. A well taken clinical history.
2. Good roentgenograms, correctly interpreted.
3. As a last resort, a biopsy made with proper care.
Exceptions do occur, as proved by the case reported in which, after the use of all these methods and with the gross and microscopic specimens available, doubt still existed as to the correct diagnosis.
It may prove that in this case we have unearthed a real entity, or, at least, a very atypical form of a classical bone lesion. In support of this the writer reports the following recent interview with Dr. James Ewing who again reviewed the specimens.
Dr. Ewing recalled his first study of the gross and microscopic specimens some three years ago and said that he had often thought of what at that time appeared to him an unusual case. He stated further that it still appeared to him to be unique, a diseased condition which, to his knowledge, had never been described. He could conceive of a finding like the above arising from a bone infection of low grade and leading to abundant plasma-cell reaction, the plasma-cell formation finally predominating as the infection subsided and leading to a condition not unlike that of the specimen. To this might be given the name 'osteomyelitic plasma-cell myeloma'.
(C) 1934 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.