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Multiple myeloma is a hematological malignancy characterized by the uncontrolled proliferation of plasma cells in the bone marrow. One of the hallmark clinical manifestations of this condition is bone pain, which arises primarily from the direct effects of myeloma on the skeletal system. The presence of neoplastic plasma cells leads to bone destruction and lesions, resulting in pathological fractures and significant discomfort. Patients often report pain in the back, ribs, and long bones due to the lytic bone lesions that are commonly found in this disease.

In contrast, while arthralgia and myalgia can be experienced by patients with various conditions, they are not specific or predominant clinical features of multiple myeloma. Erythema nodosum is associated with a variety of other diseases, primarily involving infections or inflammatory conditions, and is also not a common finding in multiple myeloma. Thus, bone pain stands out as a direct consequence of the disease's pathophysiology, making it the most representative manifestation associated with multiple myeloma.