Multiple myeloma physical examination: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Multiple myeloma}} | {{Multiple myeloma}} | ||
{{CMG}} | {{CMG}} {{AE}} {{HMHJ}}; {{HL}}; {{shyam}} | ||
==Overview== | ==Overview== | ||
Patients with multiple usually appear fatigued and lethargic. | [[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> | ||
==Physical Examination== | ==Physical Examination== | ||
===General appearance=== | ===General appearance=== | ||
*[[ | *[[Multiple myeloma]] patients often appear [[lethargic]] and [[Fatigue|fatigued]] | ||
===Vital Signs=== | ===Vital Signs=== | ||
*Low-grade [[fever]] | *Low-grade [[fever]] may be present | ||
===Skin=== | |||
*[[Pallor]] | |||
*[[Ecchymoses]] | |||
*[[Purpura]] | |||
===HEENT=== | ===HEENT=== | ||
*[[Lymphadenopathy]] | *[[Lymphadenopathy]] | ||
*Conjuctival [[pallor]] | *[[Conjuctiva|Conjuctival]] [[pallor]] | ||
*Visual defects | *[[Visual]] defects | ||
*Exudative | *[[Exudative]] [[retinal]] detachment | ||
*[[Retinal haemorrhage]] | *[[Retinal haemorrhage]] | ||
*Increased | *Increased [[adipose]] deposition around the [[neck]] (if [[dexamethasone]] is used for therapy) | ||
*[[ | *[[Cotton-wool spots]] may be present | ||
===Abdomen=== | ===Abdomen=== | ||
*[[Hepatomegaly]] | *[[Hepatomegaly]] | ||
*[[Splenomegaly]] | |||
*Abdominal tenderness (if hypercalcemia is present) | |||
===Skeletal=== | ===Skeletal=== | ||
*[[Tinel's sign]] | *Bony [[tenderness]] along [[cervical]], [[thoracic]], and [[lumbar]] [[spine]] | ||
*[[Phalen's maneuver|Phalen sign]] | *Bony [[tenderness]] in long [[bones]] | ||
*[[Tinel's sign]] may be present | |||
*[[Phalen's maneuver|Phalen sign]] may be present | |||
=== | ===Neurologic=== | ||
*[[ | *Dermatomal [[sensory loss]] | ||
*[[ | *Altered [[sensation]] | ||
*[[ | *[[Neuropathy]] | ||
=== | ===Psychiatric=== | ||
* | *Mood alterations (if [[hypercalcemia]] is present) | ||
==References== | |||
{{Reflist|2}} | |||
[[Category:Medicine]] | |||
[[Category: | |||
[[Category:Hematology]] | [[Category:Hematology]] | ||
[[Category: | [[Category:Neurology]] | ||
[[Category:Neurosurgery]] | |||
[[Category:Oncology]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Surgery]] | |||
Latest revision as of 22:47, 29 July 2020
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Multiple myeloma Microchapters |
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Multiple myeloma physical examination On the Web |
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American Roentgen Ray Society Images of Multiple myeloma physical examination |
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Risk calculators and risk factors for Multiple myeloma physical examination |
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