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1 Introduction Multiple myeloma (MM) is characterized by the clonal expansion of CD138 + /CD38 + plasma cells within a hypoxic, acidic bone marrow (BM) niche that supports tumor growth through extensive intercellular signaling ( The development of CD38-targeted therapies is complicated by the multifunctionality of the molecule

Elective surgery might be considered when you have severe pain that hasn't improved after 6-8 weeks of conservative treatment, or when pain significantly impacts your quality of life despite trying multiple approaches

With regards to subacromial impingement the pathology involves a rotator cuff dysfunction resulting in a mechanical impingement and compression of the subacromial bursa between the rotator cuff and the acromion and coracocromial ligament

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