![]() If you see a SPIKE this is called Monoclonal Gammopathy (it can remembered as the "Mother.") It is pathogonomic for Multiple Myeloma, among other badness. In the Gamma zone you will look for a SPIKE, SWELL, OR SLUMP. For example, Hyperlipidemia can increase the Beta zone (see list per globulin in below drawing.) But, most all the attention is focused on the Gamma zone because it contains the potential for malignancy. Many things can cause an increase or decrease in the 5 globulins. (Click to enlarge)Īnybody else find Protein Electrophoresis confusing? Let's dumb it down.ġst your SPEP report mentions 5 proteins called Globulins: Albumin, Alpha1, Apha2, Beta, and Gamma. All negative.)Īlpha1 (barely elevated) and Beta (Very High.) MRI of Hip/Pelvis (no new findings, but allowed for better examination of the above findings by our Orthopedics team.)Ħ. CT of Chest, Abdomen/Pelvis, Head (All negative)Ĥ. Bone Scan (Negative, accept for the known acetabulum/superior ramus lytic lesion)ģ. UPEP could not be completed inpatient.)Ģ. SPEP and UPEP (Serum Protein Electrophoresis and Urine Protein Electrophoresis) with Immunofixation (See below for SPEP. This could be from metastatic disease or myelomaġ. Expansile lytic lesion in the anterior medial wall of the leftĪcetabulum with extension into the superior pubic ramus with corticalĭestruction medially. ![]() Not ambulatory.ĬMP only significant for Low AG Ratio 0.5ĬT showing expansile lytic lesion in Superior RamusģD CT Image. Extremities: Left hip with decreased ROM secondary to pain. SH (Social History): Positive Tobacco use - 1ppd (1 pack per day) x 30+ years, Social ETOH, No illegal drug use.įH (Family History): Noncontributory. PMHx (Past Medical History): HTN, Asthma, Paroxysmal A-Fib (not anticoagulated) HPI (History of Present Illness): Patient is a 50-year-old female with a PMHx significant for HTN, Asthma, and Paroxysmal A-Fib (not anticoagulated) who presents to the ER due to progressive, now intractable, left hip pain. ![]()
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