Multiple myeloma. Diagnostic clues in a patient presenting with incapacitating arthralgias

Multiple myeloma is characterized by the production of a monoclonal immunoglobulin, free monoclonal light chains, or both. Although bone pain is the classic presentation, multiple myeloma should be a consideration in differential diagnosis in elderly patients with arthritic complaints if other typical symptoms or laboratory abnormalities, such as anemia, hypercalcemia, and elevated ESR, are present. A combination of radiation therapy and chemotherapy is the usual treatment.