This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Radiology
[{'content': 'In early cases multiple myeloma presents with: \nSelect and explain. \nA. No radiographic sign, B. Punched out lesions, C. Hair end on appearance, D. Step ladder appearance', 'role': 'user'}, {'content': 'Answer: A \nExplanation: None', 'role': 'assistant'}]