Tagliafico et al reported the Myeloma Spine and Bone Damage Score (MSBDS) for evaluating a patient with multiple myeloma. The authors are from University of Genoa and OspedalePoliclinico San Martino in Genoa, Italy.
Patient selection: multiple myeloma
Analysis: whole body CT with bone window
Parameters:
(1) junctional spine (C0 to C2, C7 to T2, T11 to L1, L5 and S1)
(2) mobile spine (C3 to C6, L2 to L4)
(3) semi rigid spine (T3 to T10)
(4) collapse in percent
(5) posterolateral (facet, pedicle) involvement
(6) spinal canal involvement
(7) femur
(8) percent involvement of bone diameter
(9) diameter of focal lesion in mm, any site
(10) diffuse pattern
|
Parameter
|
Finding
|
Points
|
|
junctional spine
|
no
|
0
|
|
|
yes
|
3
|
|
mobile spine
|
no
|
0
|
|
|
yes
|
2
|
|
semi-rigid spine
|
no
|
0
|
|
|
yes
|
1
|
|
collapse
|
< 50%
|
2
|
|
|
>= 50%
|
0
|
|
posterolateral
|
none
|
0
|
|
|
unilateral
|
2
|
|
|
bilateral
|
3
|
|
spinal canal
|
no
|
0
|
|
|
yes
|
5
|
|
femur
|
none
|
0
|
|
|
focal lesion in trochanteric region < 10 mm
|
2
|
|
|
femoral neck
|
5
|
|
|
entire trochanteric region
|
5
|
|
percent involvement of bone diameter
|
< 66%
|
0
|
|
|
>= 66%
|
3
|
|
focal lesion
|
<= 5 mm
|
0
|
|
|
> 5 mm
|
1
|
|
diffuse pattern
|
none
|
0
|
|
|
any
|
1 point for every segment
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: > 30 (depends on number of segments involved)
|
Total Score
|
Risk
|
Response
|
|
< 5
|
low
|
|
|
5 to 10
|
medium; possible instability or pathologic fracture
|
|
|
> 10
|
high
|
immediate consultation
|
