1. Bone pain and fracture: The bone destruction in multiple myeloma is mainly caused by the activation of osteoclasts by M protein secreted by plasma cells, resulting in local bone destruction or generalized osteoporosis. Some patients may experience a sudden increase in bone pain, which may be indicative of a pathologic fracture. Here we should especially point out the low back pain in some elderly patients, because this is a common symptom of the elderly, and osteoporosis, osteophytes, degenerative osteoarthropathy, disc herniation and other common orthopedic diseases of the elderly can appear as low back pain, so when there is no bone destruction and other symptoms are neglected, many patients tend to only follow the orthopedic diseases for conventional symptomatic treatment such as pain relief, which is very likely to lead to misdiagnosis. 2. Renal insufficiency: Kidney damage is also one of the common symptoms of this disease, which may mainly appear as proteinuria, or hypertension, swelling, oliguria and other manifestations of renal insufficiency, and some patients are not even found to be multiple myeloma until the uremic phase. I have a patient with proteinuria who was treated in the nephrology department for more than 1 year and finally found out that it was multiple myeloma only after he had a fracture. 3. Anemia: 90% of patients present with anemia at the first visit, and the degree of anemia is mainly mild to moderate. 4. Infection, bleeding, etc.: Patients often present with unexplained fever, cough, frequent urination, weakness, bleeding gums, excessive menstruation, etc. When the changes in blood routine are not obvious, they often do not go to the hematology department, which is prone to miss and misdiagnosis. Like Professor Huang showed symptoms of upper respiratory tract infection, mistakenly thought it was due to the flu, resulting in a delay in diagnosis and treatment, which is a pity. 5, high viscosity syndrome: mainly manifested as dizziness, hand and foot numbness, weakness, chest tightness, memory loss, etc. Its symptoms are more lack of specificity, and patients are mostly seen in neurology and cardiology.