POEMS syndrome physical examination: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{POEMS syndrome}} | {{POEMS syndrome}} | ||
{{CMG}} {{AE}} {{HK}} | {{CMG}} {{AE}} {{HK}}{{Sab}} | ||
== Overview == | == Overview == | ||
| Line 9: | Line 9: | ||
===Appearance=== | ===Appearance=== | ||
* [[Anasarca]] or [[ascites]] may be present. | * [[Anasarca]] or [[ascites]] may be present. | ||
===Vital Signs=== | |||
* Vital signs of [[Patient|patients]] with POEMS syndrome are usually normal. | |||
===Skin=== | ===Skin=== | ||
* [[Hyperpigmentation]] | |||
* [[Nail clubbing]] | *[[Hyperpigmentation]] | ||
* [[Leuconychia]] | *[[Nail clubbing]] | ||
* Thickening of the skin | *[[Leuconychia]] | ||
* Thickening of the skin<ref name="pmid25888197">{{cite journal |vauthors=Güneş HN, Bilecenoğlu NT, Şener U, Yoldaş TK |title=POEMS syndrome with peripheral and central nervous system demyelination: case report |journal=Neurologist |volume=19 |issue=4 |pages=101–3 |date=April 2015 |pmid=25888197 |doi=10.1097/NRL.0000000000000017 |url=}}</ref> | |||
* Excess hair or hair in unusual places ([[hypertrichosis]]) | * Excess hair or hair in unusual places ([[hypertrichosis]]) | ||
* Skin [[angioma]]s or [[haemangioma]]s | * Skin [[angioma]]s or [[haemangioma]]s<ref name="pmid25888197">{{cite journal |vauthors=Güneş HN, Bilecenoğlu NT, Şener U, Yoldaş TK |title=POEMS syndrome with peripheral and central nervous system demyelination: case report |journal=Neurologist |volume=19 |issue=4 |pages=101–3 |date=April 2015 |pmid=25888197 |doi=10.1097/NRL.0000000000000017 |url=}}</ref> | ||
* There may be changes reminiscent of [[scleroderma]] | * There may be changes reminiscent of [[scleroderma]] | ||
=== | ===HEENT=== | ||
* [[ | |||
* [[Papilledema]] | |||
* [[Uveitis]] and [[preretinal haemorrhage]] may be present. | * [[Uveitis]] and [[preretinal haemorrhage]] may be present. | ||
===Abdomen=== | === Neck === | ||
* [[Lymphadenopathy]] | |||
=== Lungs === | |||
* [[Pleural effusion]] (decreased or absent breath sounds, decreased [[tactile fremitus]], dullness to [[percussion]]) | |||
=== Heart === | |||
* [[Pericardial effusion]] ([[muffled heart sounds]], [[jugular venous distension]]) | |||
=== Abdomen === | |||
* [[Hepatomegaly]] | * [[Hepatomegaly]] | ||
* [[Splenomegaly]] | * [[Splenomegaly]] | ||
* [[Ascites]] (succession splash, [[shifting dullness]]) | * [[Ascites]] (succession splash, [[shifting dullness]]) | ||
=== | === Back === | ||
* [[ | |||
* Back [[Physical examination|examination]] of [[Patient|patients]] with POEMS syndrome is usually normal. | |||
=== Genitourinary === | |||
* [[Genitourinary system|Genitourinary]] [[Physical examination|examination]] of [[patients]] with POEMS syndrome is usually normal. | |||
* [[ | |||
=== | === Neuromuscular === | ||
* [[ | * Symmetrical, ascending chronic progressive [[polyneuropathy]] with both [[Sensory system|sensory]] (pin-prick and vibration) and motor disability (motor > sensory) | ||
*Decreased muscle strength<ref name="pmid25888197">{{cite journal |vauthors=Güneş HN, Bilecenoğlu NT, Şener U, Yoldaş TK |title=POEMS syndrome with peripheral and central nervous system demyelination: case report |journal=Neurologist |volume=19 |issue=4 |pages=101–3 |date=April 2015 |pmid=25888197 |doi=10.1097/NRL.0000000000000017 |url=}}</ref> | |||
*Absent deep tendon reflexes<ref name="pmid25888197">{{cite journal |vauthors=Güneş HN, Bilecenoğlu NT, Şener U, Yoldaş TK |title=POEMS syndrome with peripheral and central nervous system demyelination: case report |journal=Neurologist |volume=19 |issue=4 |pages=101–3 |date=April 2015 |pmid=25888197 |doi=10.1097/NRL.0000000000000017 |url=}}</ref> | |||
*Impaired temperature, position, and vibration senses<ref name="pmid25888197">{{cite journal |vauthors=Güneş HN, Bilecenoğlu NT, Şener U, Yoldaş TK |title=POEMS syndrome with peripheral and central nervous system demyelination: case report |journal=Neurologist |volume=19 |issue=4 |pages=101–3 |date=April 2015 |pmid=25888197 |doi=10.1097/NRL.0000000000000017 |url=}}</ref> | |||
=== | === Extremities === | ||
* [[ | * [[Bones]] may have [[Sclerosis|sclerotic]], [[lytic]] with [[Sclerosis|sclerotic]] rims or mixed [[Sclerosis|sclerotic]]/[[lytic]] [[lesions]] with soap-bubble appearance. | ||
==References== | ==References== | ||
Latest revision as of 14:10, 9 August 2019
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POEMS syndrome Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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POEMS syndrome physical examination On the Web |
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American Roentgen Ray Society Images of POEMS syndrome physical examination |
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Risk calculators and risk factors for POEMS syndrome physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]Sabawoon Mirwais, M.B.B.S, M.D.[3]
Overview
Common physical examination findings of POEMS syndrome include, organomegaly (hepatomegaly, splenomegaly), peripheral edema/anasarca, ascites, mixed lytic/sclerotic bone lesions, papilledema, skin hyperpigmentation and lymphadenopathy.
Physical Examination
Appearance
Vital Signs
- Vital signs of patients with POEMS syndrome are usually normal.
Skin
- Hyperpigmentation
- Nail clubbing
- Leuconychia
- Thickening of the skin[1]
- Excess hair or hair in unusual places (hypertrichosis)
- Skin angiomas or haemangiomas[1]
- There may be changes reminiscent of scleroderma
HEENT
- Papilledema
- Uveitis and preretinal haemorrhage may be present.
Neck
Lungs
- Pleural effusion (decreased or absent breath sounds, decreased tactile fremitus, dullness to percussion)
Heart
Abdomen
- Hepatomegaly
- Splenomegaly
- Ascites (succession splash, shifting dullness)
Back
- Back examination of patients with POEMS syndrome is usually normal.
Genitourinary
- Genitourinary examination of patients with POEMS syndrome is usually normal.
Neuromuscular
- Symmetrical, ascending chronic progressive polyneuropathy with both sensory (pin-prick and vibration) and motor disability (motor > sensory)
- Decreased muscle strength[1]
- Absent deep tendon reflexes[1]
- Impaired temperature, position, and vibration senses[1]
Extremities
- Bones may have sclerotic, lytic with sclerotic rims or mixed sclerotic/lytic lesions with soap-bubble appearance.