Multiple myeloma physical examination

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

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Physical Examination

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.

Skin: Ecchymoses or purpura from thrombocytopenia may be evident.

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.

Gastrointestinal system: Hepatosplenomegaly

Cardiovascular system: Cardiomyopathy from plasma protein deposition.

Bony and muscular system: Pain without tenderness is a feature highly specific for multiple myeloma, though not diagnostic. Pathological fractures are also pretty common.

Extramedullary plasmacytomas, which consist of soft-tissue masses of plasma cells, are not uncommon.

Amyloidosis may develop in some patients with MM. The characteristic physical examination findings that suggest amyloidosis include the following:

• Shoulder pad sign - Fat deposition around shoulders.
• Macroglossia
• Purpura
• Carpal tunnel syndrome