Multiple myeloma physical examination: Difference between revisions

	Multiple myeloma Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Multiple Myeloma from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Criteria
Staging
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X Ray
Echocardiograph and Ultrasound
CT
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Future or Investigational Therapies
Case Studies
Case #1
Multiple myeloma physical examination On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Multiple myeloma physical examination All Images X-rays Echo and Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Multiple myeloma physical examination
CDC on Multiple myeloma physical examination
Multiple myeloma physical examination in the news
Blogs on Multiple myeloma physical examination
Directions to Hospitals Treating Multiple myeloma
Risk calculators and risk factors for Multiple myeloma physical examination

← Older edit

VisualWikitext

Latest revision as of 22:47, 29 July 2020

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

Multiple myeloma patients often appear lethargic and fatigued

Vital Signs

Low-grade fever may be present

Skin

HEENT

Lymphadenopathy
Conjuctival pallor
Visual defects
Exudative retinal detachment
Retinal haemorrhage
Increased adipose deposition around the neck (if dexamethasone is used for therapy)
Cotton-wool spots may be present

Abdomen

Hepatomegaly
Splenomegaly
Abdominal tenderness (if hypercalcemia is present)

Skeletal

Bony tenderness along cervical, thoracic, and lumbar spine
Bony tenderness in long bones
Tinel's sign may be present
Phalen sign may be present

Neurologic

Dermatomal sensory loss
Altered sensation
Neuropathy

Psychiatric

Mood alterations (if hypercalcemia is present)

References

↑ Multiple myeloma. Wikipedia (2015) https://en.wikipedia.org/wiki/Multiple_myeloma#Signs_and_symptoms Accessed on September, 20th 2015
↑ 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

[N-1] Multiple myeloma. Wikipedia (2015) https://en.wikipedia.org/wiki/Multiple_myeloma#Signs_and_symptoms Accessed on September, 20th 2015

[C-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

[1]

[2]

@@ Line 1: / Line 1: @@
+__NOTOC__
 {{Multiple myeloma}}
+{{CMG}} {{AE}} {{HMHJ}}; {{HL}}; {{shyam}}
-'''Head, ears, eyes, nose, and throat (HEENT) examination:''' Pallor is one of the most evident physical findings associated with multiple myeloma. Additionally eyes may show exudative macular detachment, retinal hemorrhage, or cotton-wool spots.  Ecchymoses or purpura from thrombocytopenia may be evident.
+==Overview==
+[[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>
-'''Central nervous system:''' It includes altered sensations, dermatomal sensory loss resulting from cord compression and neuropathy, myopathy, a Tinel sign, or a Phalen sign due to carpel tunnel compression secondary to amyloid deposition.
+==Physical Examination==
-'''Gastrointestinal system:''' Hepatosplenomegaly
+===General appearance===
+*[[Multiple myeloma]] patients often appear [[lethargic]] and [[Fatigue|fatigued]]
-'''Cardiovascular system:''' Cardiomyopathy from plasma protein deposition.
+===Vital Signs===
+*Low-grade [[fever]] may be present
-'''Bony and muscular system:''' Pain without tenderness is a feature highly specific for multiple myeloma, though not diagnostic. Pathological fractures are also pretty common.
+===Skin===
+*[[Pallor]]
+*[[Ecchymoses]]
+*[[Purpura]]
-Extramedullary plasmacytomas, which consist of soft-tissue masses of plasma cells, are not uncommon.
+===HEENT===
+*[[Lymphadenopathy]]
+*[[Conjuctiva|Conjuctival]] [[pallor]]
+*[[Visual]] defects
+*[[Exudative]] [[retinal]] detachment
+*[[Retinal haemorrhage]]
+*Increased [[adipose]] deposition around the [[neck]] (if [[dexamethasone]] is used for therapy)
+*[[Cotton-wool spots]] may be present
-'''Amyloidosis''' may develop in some patients with MM. The characteristic physical examination findings that suggest amyloidosis include the following:
+===Abdomen===
-:* Shoulder pad sign
+*[[Hepatomegaly]]
-:* Macroglossia
+*[[Splenomegaly]]
-:* Purpura
+*Abdominal tenderness (if hypercalcemia is present)
-:* Carpal tunnel syndrome
-== 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]]
-[[Category:Oncology]]
+*Altered [[sensation]]
-[[Category:Hematology]]
+*[[Neuropathy]]
-{{WikiDoc Help Menu}}
+===Psychiatric===
+*Mood alterations (if [[hypercalcemia]] is present)
+==References==
+{{Reflist|2}}
-{{WikiDoc Sources}}
+[[Category:Medicine]]
+[[Category:Hematology]]
-[[Category:Needs content]]
+[[Category:Neurology]]
+[[Category:Neurosurgery]]
+[[Category:Oncology]]
+[[Category:Up-To-Date]]
+[[Category:Surgery]]