Moth-Eaten Pattern

One early definition of the moth eaten pattern of bone destruction was given by Webster Belden ¹ (New York Hospital) in 1925. While describing a case of multiple myeloma, he said, ‘The lesions are multiple and the bones are pierced by small focal spots of destruction which are not confluent.’’ Although Belden did not use the term moth eaten, Ernest Codman ² used it that same year, to describe the radiographic appearance of multiple myeloma, which ‘may at times show invasion of the bone in a moth-eaten way.’ This pattern of destruction is not specific for myeloma since it can be seen with many other aggressive primary bone tumors and at times with aggressive non-neoplastic conditions like osteomyelitis (Figure 1). Figure 1 Moth eaten pattern of destruction. From <italic>The Bones and Joints</italic> by Lodwick (1971)<xref ref-type="bibr" rid="ref57_5"> ⁵ </xref>, published by Year Book Medical Publishers, Chicago. Copyright 1971 with ACR. Reprinted with permission https://s3-euw1-ap-pe-df-pch-content-public-p.s3.eu-west-1.amazonaws.com/9781003076568/34c29fd5-5662-4e8f-b58c-badd7fa5d724/content/fig57_1_B.jpg"/>