Which physical findings are characteristic of multiple myeloma (MM)?

Updated: Jul 15, 2019
  • Author: Dhaval Shah, MD; Chief Editor: Emmanuel C Besa, MD  more...
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Answer

Examination for MM may reveal the following:

  • HEENT examination: Exudative macular detachment, retinal hemorrhage, or cotton-wool spots
  • Dermatologic evaluation: Pallor from anemia, ecchymoses or purpura from thrombocytopenia; extramedullary plasmacytomas (most commonly in aerodigestive tract but also orbital, ear canal, cutaneous, gastric, rectal, prostatic, retroperitoneal areas)
  • Musculoskeletal examination: Bony tenderness or pain without tenderness
  • Neurologic assessment: Sensory level change (ie, loss of sensation below a dermatome corresponding to a spinal cord compression), neuropathy, myopathy, positive Tinel sign, or positive Phalen sign
  • Abdominal examination: Hepatosplenomegaly
  • Cardiovascular evaluation: Cardiomegaly

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