Myeloma and plasma cell disorders practice

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Any stageFoundations71Mechanisms of disease35Clinical rotations832Pre-internship488

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Haematology and Oncologycommon

A 68-year-old man reports persistent thoracic back pain and fatigue for 3 months. His haemoglobin is 92 g/L (reference range 130–170), creatinine is 180 micromol/L (60–110) and corrected calcium is 2.86 mmol/L (2.10–2.60). Plain radiography shows several punched-out lucencies in the skull. Which investigation best establishes whether a monoclonal plasma-cell disorder is present?