{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T06:45:14Z","timestamp":1772174714732,"version":"3.50.1"},"reference-count":18,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,4,23]]},"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:p>Although solitary plasmacytomas may occasionally present as collar bone swellings or fractures, multiple myeloma involving clavicle is extremely rare. Ten to forty per cent of multiple myeloma cases are asymptomatic and are incidental diagnoses. Our case report describes an entirely benign presentation like chronic shoulder pain masquerading advanced myeloma, thereby posing a significant diagnostic dilemma. We present a 48-year-old man who presented with chronic bilateral shoulder pain with no history of trauma and was eventually diagnosed with advanced multiple myeloma and pathologic fracture of the right clavicle. It is, therefore, evident that a low threshold for suspicion can lead to early diagnosis and initiation of treatment and better survival.<\/jats:p>","DOI":"10.1136\/bcr-2019-231219","type":"journal-article","created":{"date-parts":[[2020,5,28]],"date-time":"2020-05-28T06:26:52Z","timestamp":1590647212000},"page":"e231219","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Advanced myeloma masquerading as chronic shoulder pain in a 48-year-old man: a diagnostic dilemma"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5211-1285","authenticated-orcid":false,"given":"Rajarshi","family":"Bhadra","sequence":"first","affiliation":[{"name":"Internal Medicine, St Vincent Charity Medical Center, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teodora","family":"Nikova","sequence":"additional","affiliation":[{"name":"Internal Medicine, Northeast Ohio Medical University, Rootstown, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meyappan","family":"Somasundaram","sequence":"additional","affiliation":[{"name":"Internal Medicine, St Vincent Charity Medical Center, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keyvan","family":"Ravakhah","sequence":"additional","affiliation":[{"name":"Internal Medicine, St Vincent Charity Medical Center, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,5,27]]},"reference":[{"key":"2025082803280396000_13.5.e231219.1","first-page":"853","article-title":"Multiple myeloma: diagnosis and treatment","volume":"78","author":"Nau","year":"2008","journal-title":"Am Fam Physician"},{"key":"2025082803280396000_13.5.e231219.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbo.2013.04.001"},{"key":"2025082803280396000_13.5.e231219.3","unstructured":"Stats F . An interactive tool for access to SEER cancer statistics. Edition Bathesda, MD: National Cancer Institute, 2010."},{"key":"2025082803280396000_13.5.e231219.4","doi-asserted-by":"crossref","first-page":"103","DOI":"10.4172\/2157-7099.1000103","article-title":"Solitary Plasmacytoma of Clavicle - A Rare Case Presentation","volume":"01","author":"Shahid","year":"2010","journal-title":"J Cytol Histol"},{"key":"2025082803280396000_13.5.e231219.5","doi-asserted-by":"crossref","unstructured":"Suzuki S , Ikusaka M , Miyahara M , et al . Positron emission tomography findings in a patient with multiple myeloma of polymyalgia rheumatica-like symptoms caused by paraneoplastic syndrome. BMJ Case Rep 2014.","DOI":"10.1136\/bcr-2013-203326"},{"key":"2025082803280396000_13.5.e231219.6","first-page":"OD11-OD12","article-title":"Idiopathic brachial neuritis in a patient with multiple myeloma","volume":"11","author":"Cerrahoglu","year":"2017","journal-title":"J Clin Diagn Res"},{"key":"2025082803280396000_13.5.e231219.7","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyt169"},{"key":"2025082803280396000_13.5.e231219.8","first-page":"379","article-title":"Case report 621. multiple myeloma (IgD) in a 28-year-old woman","volume":"19","author":"Hermann","year":"1990","journal-title":"Skeletal Radiol"},{"key":"2025082803280396000_13.5.e231219.9","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/BF01682035","article-title":"Presenting signs and symptoms in multiple myeloma: high percentages of stage III among patients without apparent myeloma-associated symptoms","volume":"70","author":"Ong","year":"1995","journal-title":"Ann Hematol"},{"key":"2025082803280396000_13.5.e231219.10","doi-asserted-by":"publisher","DOI":"10.1359\/JBMR.041131"},{"key":"2025082803280396000_13.5.e231219.11","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.22991"},{"key":"2025082803280396000_13.5.e231219.12","doi-asserted-by":"publisher","DOI":"10.1102\/1470-7330.2010.0013"},{"key":"2025082803280396000_13.5.e231219.13","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.2311020452"},{"key":"2025082803280396000_13.5.e231219.14","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-198009000-00005"},{"key":"2025082803280396000_13.5.e231219.15","first-page":"CD004023","article-title":"Early versus deferred treatment for early stage multiple myeloma","volume":"1","author":"He","year":"2003","journal-title":"Cochrane Database Syst Rev"},{"key":"2025082803280396000_13.5.e231219.16","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1056\/NEJMoa1611750","article-title":"Lenalidomide, bortezomib, and dexamethasone with transplantation for myeloma","volume":"376","author":"Attal","year":"2017","journal-title":"N Engl J Med"},{"key":"2025082803280396000_13.5.e231219.17","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1402888"},{"key":"2025082803280396000_13.5.e231219.18","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1011442"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-231219","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:28:15Z","timestamp":1756376895000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-231219"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5]]},"references-count":18,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2020,5,27]]},"published-print":{"date-parts":[[2020,5]]}},"alternative-id":["10.1136\/bcr-2019-231219"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-231219","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5]]}}}