Clinical Case: Hypercalcemia due to Multiple Myeloma

60 year old female presented to the ER complaining of back pain, weakness and decreased appetite for one week.

PMH:
Diverticulitis

Physical examination:
VSS
Limited movement in the lumbar spine
No focal neurological changes

Laboratory results:
H/H of 7.7/23
Platelets of 106
BUN of 35, Cr of 2.7
Ca of 16.6, repeated Ca is still 16.2

Survey radiographs of the skull, spine, ribs, pelvis and upper and lower extremities (large bones):

X-ray of skull, CXR, spine

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