Multiple myeloma physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Haytham Allaham, M.D. [2]

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.

Physical Examination

General appearance

• Multiple myeloma patients often appear lethargic and fatigued

Vital Signs

• Low-grade fever may be present

Skin

• Pallor may be present
• Ecchymoses may be present
• Purpura may be present

HEENT

• Lymphadenopathy may be present
• Conjuctival pallor may be present
• Visual defects may be present
• Exudative retinal detachment
• Retinal haemorrhage may be present
• Increased fat around the neck may be present
• Cotton-wool spots may be present
• Shoulder pad sign may be present due to amyloid deposition around shoulders

Abdomen

• Hepatomegaly may be present

Skeletal

• Tinel's sign may be present
• Phalen sign may be present

CNS

• Dermatomal sensory loss
• Altered sensation may be present