What investigation is primarily used to detect osteolytic lesions in multiple myeloma?

The investigation primarily used to detect osteolytic lesions in multiple myeloma is whole body MRI. This imaging technique is particularly effective because it provides detailed information about the bone marrow and is sensitive to changes that occur in the acute phase of multiple myeloma. Unlike X-rays, which may miss early osteolytic lesions or can only provide a two-dimensional view, whole body MRI offers a comprehensive assessment of the skeletal system, allowing for the detection of subtle bone marrow infiltrations and lesions that characterize multiple myeloma.

Whole body MRI helps visualize multiple lesions that may be present throughout the body, making it a valuable tool in both diagnosis and monitoring disease progression. It is also non-invasive and avoids exposure to ionizing radiation, which is an added benefit in patients requiring repeated imaging.

In comparison, while CT scans can also identify lesions and provide good detail, they can expose patients to higher doses of radiation and might not be as comprehensive as whole body MRI in evaluating the extent of skeletal involvement. Conventional X-rays may show osteolytic lesions, but they are less sensitive than MRI and often are not able to detect smaller lesions or early changes associated with myeloma. Ultrasound is generally not used for this purpose as it cannot adequately visualize bone lesions,