This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Myeloma, Subject name: Medicine
Commonest site of lytic lesion in multiple myeloma is - 
Select and explain. 
A. Femur, B. Clavicle, C. Pelvis, D. Vertebral column
D: Vertebral column
Answer: D: Vertebral column 
Explanation: Ans. is 'd' i.e., Vertebral column o Bone lesions are most common in vertebral column. The pain usually involves the back and ribs, and unlike the pain of metastatic carcinoma, which often is worse at night, the pain of myeloma is precipitated by movement. Persistent localized pain in a patient with myeloma usually signifies a pathologic fracture. o The most common site of lytic lesion in multiple myeloma is vertebra > Skull > ribs. Distal to elbow and knee lesions are not seen.