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| Investigation | Purpose | Key Findings / Considerations |
|---|---|---|
| Complete Blood Count (CBC) | Assess overall blood cell counts | Anemia, leukopenia, thrombocytopenia (multiple myeloma, malignancies). |
| Serum Calcium and Phosphate | Assess bone metabolism | Hypercalcemia (multiple myeloma), hypocalcemia (osteomalacia). |
| Alkaline Phosphatase (ALP) | Assess bone turnover | Elevated in bone diseases like Paget's disease, osteomalacia. |
| Serum Protein Electrophoresis (SPEP) | Detect abnormal proteins | Monoclonal protein spike (multiple myeloma). |
| Urine Bence Jones Protein | Detect light chains in urine | Presence of Bence Jones proteins (multiple myeloma). |
| Serum Vitamin D Level | Assess for vitamin D deficiency | Low in osteomalacia. |
| Thyroid Function Tests | Assess thyroid function | Hyperthyroidism or hypothyroidism affecting bone density. |
| Erythrocyte Sedimentation Rate (ESR) | Assess inflammation | Elevated in inflammatory conditions, multiple myeloma. |
| C-Reactive Protein (CRP) | Assess inflammation | Elevated in inflammatory conditions, infections. |
| Renal Function Tests | Assess kidney function | Elevated creatinine and BUN (multiple myeloma affecting kidneys). |
| X-ray of the Lumbar Spine | Assess bone structure | Osteopenia, fractures (osteoporosis, osteomalacia), lytic lesions (myeloma). |
| Magnetic Resonance Imaging (MRI) of the Spine | Detailed imaging of soft tissues and bone structures | Identifies spinal stenosis, disc herniation, bone lesions (multiple myeloma). |
| Category | Red Flags / Symptoms |
|---|---|
| Cauda Equina Syndrome | - Sudden-onset bilateral... |
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