Growth hormone deficiency physical examination: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Growth hormone deficiency}} | {{Growth hormone deficiency}} | ||
{{CMG}}; {{AE}} | {{CMG}}; {{AE}} {{MAD}} | ||
==Overview== | ==Overview== | ||
Patients with growth hormone deficiency usually look tired and less energetic than normal subjects. Extremities show [[Clubbing]], [[muscle atrophy]], [[neonatal jaundice]], [[Cyanosis|neonatal cyanosis]]. Head may show infantile facies, [[Dentition|delayed dentition]], and brittle hair. Children may show [[hyporeflexia]] and [[delayed puberty]]. | |||
==Physical Examination== | ==Physical Examination== | ||
===Appearance of the Patient=== | ===Appearance of the Patient=== | ||
* | *Children with growth hormone deficiency usually look tired and less energetic than normal subjects of the same age with infantile doll-like body shape. | ||
*In adults, increased lean [[body mass]] causes [[weight gain]], especially around the [[waist]].<ref name="pmid25070016">{{cite journal| author=Fukuda I, Hizuka N, Muraoka T, Ichihara A| title=Adult growth hormone deficiency: current concepts. | journal=Neurol Med Chir (Tokyo) | year= 2014 | volume= 54 | issue= 8 | pages= 599-605 | pmid=25070016 | doi= | pmc=4533495 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25070016 }}</ref> | |||
=== Back === | === Back === | ||
Osteoporosis and tenderness of the lumbar | * [[Osteoporosis]] and tenderness of the [[Lumbar spine|lumbar spine]] are higher in patients compared with normal subjects.<ref name="pmid22157400">{{cite journal| author=Stanley T| title=Diagnosis of growth hormone deficiency in childhood. | journal=Curr Opin Endocrinol Diabetes Obes | year= 2012 | volume= 19 | issue= 1 | pages= 47-52 | pmid=22157400 | doi=10.1097/MED.0b013e32834ec952 | pmc=3279941 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22157400 }}</ref> | ||
===Vital Signs=== | ===Vital Signs=== | ||
*[[Hypothermia]] | *[[Hypothermia]] associated with [[hypothyroidism]] | ||
===Skin=== | ===Skin=== | ||
| Line 23: | Line 24: | ||
===HEENT=== | ===HEENT=== | ||
* | * Infantile facies | ||
* Delayed [[Dentition|dentition]] | |||
* Brittle hair. | |||
===Neck=== | ===Neck=== | ||
*[[Carotid bruits]] may be auscultated unilaterally/bilaterally due to high rate of atherosclerosis | *[[Carotid bruits]] may be auscultated unilaterally/bilaterally due to the high rate of [[atherosclerosis]].<ref name="pmid26550626" /> | ||
===Abdomen=== | ===Abdomen=== | ||
*[[Abdominal distention]] | *[[Abdominal distention]] | ||
===Genitourinary=== | ===Genitourinary=== | ||
*Cryptorchidism and micropenis in infants | *[[Cryptorchidism]] and [[micropenis]] in infants<ref name="pmid27974187" /> | ||
*Delayed puberty in children | *[[Delayed puberty]] in children<ref name="pmid26550626">{{cite journal| author=Nielsen J, Jensen RB, Afdeling AJ| title=[Growth hormone deficiency in children]. | journal=Ugeskr Laeger | year= 2015 | volume= 177 | issue= 26 | pages= 1260-3 | pmid=26550626 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26550626 }}</ref> | ||
===Neuromuscular=== | ===Neuromuscular=== | ||
* Hyporeflexia | * [[Hyporeflexia]] | ||
* Muscle weakness bilaterally | * [[Muscle weakness]] bilaterally | ||
===Extremities=== | ===Extremities=== | ||
| Line 44: | Line 47: | ||
*[[Jaundice]] in neonates | *[[Jaundice]] in neonates | ||
*Pitting/non-pitting [[edema]] | *Pitting/non-pitting [[edema]] | ||
*Muscle atrophy | *[[Muscle atrophy]]<ref name="pmid27974187">{{cite journal| author=Chinoy A, Murray PG| title=Diagnosis of growth hormone deficiency in the paediatric and transitional age. | journal=Best Pract Res Clin Endocrinol Metab | year= 2016 | volume= 30 | issue= 6 | pages= 737-747 | pmid=27974187 | doi=10.1016/j.beem.2016.11.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27974187 }}</ref> | ||
==References== | ==References== | ||
Latest revision as of 20:21, 26 October 2017
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Growth hormone deficiency Microchapters |
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Differentiating Growth hormone deficiency from other Diseases |
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Diagnosis |
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Growth hormone deficiency physical examination On the Web |
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American Roentgen Ray Society Images of Growth hormone deficiency physical examination |
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Risk calculators and risk factors for Growth hormone deficiency physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]
Overview
Patients with growth hormone deficiency usually look tired and less energetic than normal subjects. Extremities show Clubbing, muscle atrophy, neonatal jaundice, neonatal cyanosis. Head may show infantile facies, delayed dentition, and brittle hair. Children may show hyporeflexia and delayed puberty.
Physical Examination
Appearance of the Patient
- Children with growth hormone deficiency usually look tired and less energetic than normal subjects of the same age with infantile doll-like body shape.
- In adults, increased lean body mass causes weight gain, especially around the waist.[1]
Back
- Osteoporosis and tenderness of the lumbar spine are higher in patients compared with normal subjects.[2]
Vital Signs
- Hypothermia associated with hypothyroidism
Skin
HEENT
- Infantile facies
- Delayed dentition
- Brittle hair.
Neck
- Carotid bruits may be auscultated unilaterally/bilaterally due to the high rate of atherosclerosis.[3]
Abdomen
Genitourinary
- Cryptorchidism and micropenis in infants[4]
- Delayed puberty in children[3]
Neuromuscular
- Hyporeflexia
- Muscle weakness bilaterally
Extremities
- Clubbing
- Cyanosis in neonates
- Jaundice in neonates
- Pitting/non-pitting edema
- Muscle atrophy[4]
References
- ↑ Fukuda I, Hizuka N, Muraoka T, Ichihara A (2014). "Adult growth hormone deficiency: current concepts". Neurol Med Chir (Tokyo). 54 (8): 599–605. PMC 4533495. PMID 25070016.
- ↑ Stanley T (2012). "Diagnosis of growth hormone deficiency in childhood". Curr Opin Endocrinol Diabetes Obes. 19 (1): 47–52. doi:10.1097/MED.0b013e32834ec952. PMC 3279941. PMID 22157400.
- ↑ 3.0 3.1 Nielsen J, Jensen RB, Afdeling AJ (2015). "[Growth hormone deficiency in children]". Ugeskr Laeger. 177 (26): 1260–3. PMID 26550626.
- ↑ 4.0 4.1 Chinoy A, Murray PG (2016). "Diagnosis of growth hormone deficiency in the paediatric and transitional age". Best Pract Res Clin Endocrinol Metab. 30 (6): 737–747. doi:10.1016/j.beem.2016.11.002. PMID 27974187.