Multiple myeloma physical examination

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]

• Multiple myeloma patients often appear lethargic and fatigued

• Low-grade fever may be present

• Pallor
• Ecchymoses
• Purpura

• 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

• Hepatomegaly
• Splenomegaly
• Abdominal tenderness (if hypercalcemia is present)

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

• Dermatomal sensory loss
• Altered sensation
• Neuropathy

• Mood alterations (if hypercalcemia is present)