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Multiple Myeloma — UKMLA MCQ

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HardHaematologyMultiple MyelomaUKMLAMRCP Part 1

A patient with myeloma develops new severe back pain, leg weakness and urinary hesitancy. What investigation is required urgently?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Whole-spine MRI within 24 hours of specialist assessment

The best answer is “Whole-spine MRI within 24 hours of specialist assessment”. The combination suggests metastatic or malignant spinal cord compression and triggers immediate specialist coordination. Whole-spine MRI identifies the level and extent of compression and should occur within 24 hours. Plain radiographs, bone density, delayed PET and electromyography cannot safely exclude this oncological emergency.

Reference: NICE NG234: Spinal metastases and metastatic spinal cord compression: https://www.nice.org.uk/guidance/ng234/chapter/Recommendations