Sialolithiasis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mahda Alihashemi M.D. [2]

Overview

Patients with sialolithiasis usually appear normal. Physical examination of patients with sialolithiasis is usually remarkable for tenderness of the involved gland, palpable hard lump and pus discharging from the duct in cases of acute bacterial sialadenitis.

Physical Examination

Physical examination of patients with sialolithiasis is usually remarkable for: tenderness of the involved gland, palpable hard lump and pus discharging from the duct in cases of acute bacterial sialadenitis.

Appearance of the Patient

• Patients with sialolithiasis usually appear normal.

Swelling of the submandibular gland, By James Heilman, MD- via wikimediaCommons

Salivary stone in submandibular salivary duct, By James Heilman, MD- via wikimediaCommons

Vital Signs

• Vital signs are usually normal but low grade fever may be seen in sialadenititis as a complication of sialolithiasis.

Skin

• Skin examination of patients with sialolithiasis is usually normal.

HEENT

Normal salivary gland is spongy.

In sialolithiasis:

• Tenderness of the involved gland.
• Palpable hard lump near the end of the involved duct or under the tongue in submandibular duct stone.
  • Stones, sometimes may be felt smooth or irregular.
• In total obstruction, no saliva is coming from the duct.
• Erythema of the floor of the mouth in sialadenitis as a complication of sialolithiasis.
• Pus discharging from the duct in cases of infection of salivary gland ( acute bacterial sialadenitis).
• Stone in the minor salivary glands can be felt as a small nodule.
• Stones are typically rock hard and small; they may be smooth or irregular. They are most commonly felt within the ductal system.

Neck

• Cervical lymphadenopathy in the cases of infection

Lungs

• Pulmonary examination of patients with sialolithiasis is usually normal.

Heart

• Cardiovascular examination of patients with sialolithiasis is usually normal.

Abdomen

Abdominal examination of patients with sialolithiasis is usually normal.

Back

• Back examination of patients with sialolithiasis is usually normal.

Genitourinary

• Genitourinary examination of patients with sialolithiasis is usually normal.

Neuromuscular

• Neuromuscular examination of patients with sialolithiasis is usually normal.

Extremities

• Extremities examination of patients with sialolithiasis is usually normal.