The evaluation of multiple myeloma begins with a history and physical examination.

Physical findings in someone with multiple myeloma may include:

• Bone tenderness
• Numbness and tingling
• Pale skin
• Slow wound healing
• Swelling over the shoulders
• Swelling over the clavicles
• Swelling over the ribs
• Swelling over the breastbone
• Swelling over the skull
• Weakness or fatigue
• Unintentional weight loss

Tests that may be used to evaluate multiple myeloma include:

• Bone marrow biopsy
• This is the test that is used to confirm the diagnosis
• Complete blood count
• Acid phosphatase
• Erythrocyte sedimentation rate
• Cold agglutinins
• Serum calcium
• Bence Jones protein
• Abnormally elevated levels of protein in the blood and urine
• Liver profile
• Serum protein electrophoresis
• Urinalysis

Additional tests that may be used to evaluate multiple myeloma include:

• 24-hour urine collection for protein:
• Can show abnormally elevated levels of protein
• Skull and extremity x-rays
• Spine x-rays:
• May show compression fractures
• Erosions in the bones
• CT scan of the spine
• MRI scan
• Bone scan