Multiple myeloma physical examination: Difference between revisions

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


==Overview==
==Overview==
Patients with multiple myeloma usually appear fatigued and [[lethargic]]. Physical examination of patients with multiple myeloma is usually remarkable for [[pallor]], [[purpura]], [[hepatosplenomegaly]], [[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>
[[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==
<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>


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


===Vital Signs===
===Vital Signs===
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===Skin===
===Skin===
*[[Pallor]] may be present
*[[Pallor]]
*[[Ecchymoses]] may be present
*[[Ecchymoses]]
*[[Purpura]] may be present
*[[Purpura]]


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


===Abdomen===
===Abdomen===
*[[Hepatomegaly]] may be present
*[[Hepatomegaly]]  
*[[Splenomegaly]]
*Abdominal tenderness (if hypercalcemia is present)


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


===CNS===
===Neurologic===
*Dermatomal [[sensory loss]]
*Dermatomal [[sensory loss]]
*Altered sensation may be present
*Altered [[sensation]]
*[[Neuropathy]]


== References ==
===Psychiatric===
{{reflist|2}}
*Mood alterations (if [[hypercalcemia]] is present)
==References==
{{Reflist|2}}


[[Category:Disease]]
[[Category:Medicine]]
[[Category:Types of cancer]]
[[Category:Hematology]]
[[Category:Hematology]]
[[Category:Needs content]]
[[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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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