system
Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
A patient presents with pain in back. Lab investigation shows elevated ESR. X-ray skull shows multiple punched out lytic lesions. Most impoant investigation to be done is:
assistant
The correct answer is  Multiple Myeloma. Multiple punched out lytic lesions of skull Dx- M bands on serum electrophoresis. Elevated ESR is an impoant finding in multiple myeloma Punched out lesions of skull are seen in Eosinophilic granuloma-bevelled edges (double contour) Multiple myeloma.