Hepatitis D physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jolanta Marszalek, M.D. [2]; João André Alves Silva, M.D. [3]

Overview

Physical examination of patients with acute HDV infection may be normal, or include findings, such as jaundice, and some degree of impairment of joint movement due to arthralgia. Physical examination of patients with chronic disease, depending on the its stage, may include: jaundice; palmar erythema; spider angiomata;gynecomastia; hepatomegaly; splenomegaly; ascites; peripheral edema; and asterixis.

Physical Examination

The aim of the initial physical examination is to observe for the presence of signs of chronic liver disease which include the following:

Skin

• Jaundice
• Palmar erythema
• Spider angiomata
• Gynecomastia

HEENT

• Icterus

Abdomen

• Hepatomegaly
• Shrunken liver
• Splenomegaly
• Ascites
• Caput medusae

Extremities

• Peripheral edema
• Dupuytren's contracture

Neurologic

• Asterixis
• Neurologic manifestations in cases of HBV progression to hepatic encephalopathy include a wide spectrum of cognitive impairment and motor system abnormalities.

Extrahepatic Manifestations

• Arthritis-dermatitis syndrome:
  • Urticaria
  • Petechiae
  • Palpable purpura
  • Arthralgia
  • Arthritis of small joints
• Neuropathy

Gallery

Refer to the cirrhosis image gallery for images of the physical findings listed above.