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{{Multiple myeloma}}
{{Multiple myeloma}}
{{CMG}}
{{CMG}} {{AE}} {{HMHJ}}; {{HL}}; {{shyam}}


==Overview==
==Overview==
Multiple myeloma affects not only the bone marrow, but also spreads to other organ systems. This therefore, requires a detailed assessment of various organ systems. A number of times, any of these physical findings may warrant a further evaluation, and thus leads to an incidental diagnosis of multiple myeloma. [[Pallor]], [[purpura]], signs of [[cord compression]], [[hepatosplenomegaly]], bony pain without tenderness and [[carpal tunnel syndrome]] are some of the most common physical findings, in a patient presenting with multiple myeloma.
[[Patients]] with [[multiple myeloma]] usually appear [[Fatigue|fatigued]] and [[lethargic]]. Physical examination of [[patients]] with [[multiple myeloma]] is usually remarkable for [[pallor]], [[purpura]], [[hepatosplenomegaly]], bony [[tenderness]], [[carpal tunnel syndrome]],  and [[signs]] of [[cord compression]]. Any of these physical findings may warrant further evaluation, and thus lead to an incidental [[diagnosis]] of [[multiple myeloma]].<ref name="N">Multiple myeloma. Wikipedia (2015) https://en.wikipedia.org/wiki/Multiple_myeloma#Signs_and_symptoms Accessed on September, 20th 2015</ref><ref name="C">Multiple myeloma. Canadian Cancer Society (2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/signs-and-symptoms/?region=mb Accessed on September 20th 2015</ref>


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==Physical Examination==
==Physical Examination==


===General appearance===
===General appearance===
*[[Lethargic]]
*[[Multiple myeloma]] patients often appear [[lethargic]] and [[Fatigue|fatigued]]


===Vital Signs===
===Vital Signs===
*Low-grade [[fever]]
*Low-grade [[fever]] may be present
 
===Cardiovascular===
*Cardiomyopathy
 
===Abdomen===
*[[Hepatomegaly]]
 
===Skeletal===
*Bone pain without tenderness is a feature highly specific for multiple myeloma
*[[Tinel's sign]]
*[[Phalen's maneuver|Phalen sign]]


===Skin===
===Skin===
*[[Pallor]]
*[[Pallor]]
*[[Ecchymoses]]  
*[[Ecchymoses]]
*[[Purpura]]
*[[Purpura]]


===HEENT===
===HEENT===
*Conjuctival [[pallor]]
*[[Lymphadenopathy]]
*[[Lymphadenopathy]]  
*[[Conjuctiva|Conjuctival]] [[pallor]]
*Visual defects
*[[Visual]] defects
*Exudative macular detachment
*[[Exudative]] [[retinal]] detachment
*[[Retinal haemorrhage]]
*[[Retinal haemorrhage]]
*Increased fat around the neck
*Increased [[adipose]] deposition around the [[neck]] (if [[dexamethasone]] is used for therapy)
*[[cotton-wool spot|Cotton-wool spots]]
*[[Cotton-wool spots]] may be present
* Shoulder pad sign - Fat deposition around shoulders.


===CNS===
===Abdomen===
*Altered sensation
*[[Hepatomegaly]]
*Dermatomal sensory loss
*[[Splenomegaly]]
*Polyeuropathy
*Abdominal tenderness (if hypercalcemia is present)


== References ==
===Skeletal===
{{reflist|2}}
*Bony [[tenderness]] along [[cervical]], [[thoracic]], and [[lumbar]] [[spine]]
*Bony [[tenderness]] in long [[bones]]
*[[Tinel's sign]] may be present
*[[Phalen's maneuver|Phalen sign]] may be present


[[Category:Disease]]
===Neurologic===
[[Category:Types of cancer]]
*Dermatomal [[sensory loss]]
*Altered [[sensation]]
*[[Neuropathy]]
 
===Psychiatric===
*Mood alterations (if [[hypercalcemia]] is present)
==References==
{{Reflist|2}}
 
[[Category:Medicine]]
[[Category:Hematology]]
[[Category:Hematology]]
[[Category:Needs content]]
[[Category:Neurology]]
 
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Latest revision as of 22:47, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Hannan Javed, M.D.[2]; Haytham Allaham, M.D. [3]; Shyam Patel [4]

Overview

Patients with multiple myeloma usually appear fatigued and lethargic. Physical examination of patients with multiple myeloma is usually remarkable for pallor, purpura, hepatosplenomegaly, bony tenderness, carpal tunnel syndrome, and signs of cord compression. Any of these physical findings may warrant further evaluation, and thus lead to an incidental diagnosis of multiple myeloma.[1][2]

Physical Examination

General appearance

Vital Signs

  • Low-grade fever may be present

Skin

HEENT

Abdomen

Skeletal

Neurologic

Psychiatric

References

  1. Multiple myeloma. Wikipedia (2015) https://en.wikipedia.org/wiki/Multiple_myeloma#Signs_and_symptoms Accessed on September, 20th 2015
  2. Multiple myeloma. Canadian Cancer Society (2015) http://www.cancer.ca/en/cancer-information/cancer-type/multiple-myeloma/signs-and-symptoms/?region=mb Accessed on September 20th 2015