Sjögren's syndrome physical examination: Difference between revisions

Jump to navigation Jump to search
← Older edit
VisualWikitext
Farima Kahe (talk | contribs)
Bureaucrats, bureaucrats, nocaptcha, Administrators
4,723 edits
WikiBot (talk | contribs)
Bots, Bureaucrats, bureaucrats, interwiki, nocaptcha, Administrators
57,550 edits
m Bot: Removing from Primary care
 
(32 intermediate revisions by 2 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Sjögren's syndrome}}
{{Sjögren's syndrome}}
{{CMG}} {{AE}}
{{CMG}} {{AE}} {{F.K}}
 
{{PleaseHelp}}


==Overview==
==Overview==
Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
Physical examination of patients with is usually remarkable for dryness of all [[mucous membranes]] such as [[mouth]], [[Eye|eyes]], lips, [[anal]] and [[rectal]].
 
OR
 
Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].
 
OR
 
The presence of [finding(s)] on physical examination is diagnostic of [disease name].
 
OR
 
The presence of [finding(s)] on physical examination is highly suggestive of [disease name].


==Physical Examination==
==Physical Examination==
* Physical examination of patients with [disease name] is usually normal.
*Physical examination of patients with is usually remarkable for dryness of all [[mucous membranes]] such as [[mouth]], [[Eye|eyes]], lips, [[anal]] and [[rectal]].<ref name="pmid16453296">{{cite journal |vauthors=Lopate G, Pestronk A, Al-Lozi M, Lynch T, Florence J, Miller T, Levine T, Rampy T, Beson B, Ramneantu I |title=Peripheral neuropathy in an outpatient cohort of patients with Sjögren's syndrome |journal=Muscle Nerve |volume=33 |issue=5 |pages=672–6 |date=May 2006 |pmid=16453296 |doi=10.1002/mus.20514 |url=}}</ref><ref name="pmid19254127">{{cite journal |vauthors=Antoniazzi RP, Miranda LA, Zanatta FB, Islabão AG, Gustafsson A, Chiapinotto GA, Oppermann RV |title=Periodontal conditions of individuals with Sjögren's syndrome |journal=J. Periodontol. |volume=80 |issue=3 |pages=429–35 |date=March 2009 |pmid=19254127 |doi=10.1902/jop.2009.080350 |url=}}</ref><ref name="pmid19307256">{{cite journal |vauthors=Riccieri V, Sciarra I, Ceccarelli F, Alessandri C, Croia C, Vasile M, Modesti MG, Priori R, Valesini G |title=Nailfold capillaroscopy abnormalities are associated with the presence of anti-endothelial cell antibodies in Sjogren's syndrome |journal=Rheumatology (Oxford) |volume=48 |issue=6 |pages=704–6 |date=June 2009 |pmid=19307256 |doi=10.1093/rheumatology/kep051 |url=}}</ref><ref name="pmid18085734">{{cite journal |vauthors=Ren H, Wang WM, Chen XN, Zhang W, Pan XX, Wang XL, Lin Y, Zhang S, Chen N |title=Renal involvement and followup of 130 patients with primary Sjögren's syndrome |journal=J. Rheumatol. |volume=35 |issue=2 |pages=278–84 |date=February 2008 |pmid=18085734 |doi= |url=}}</ref><ref name="pmid16397619">{{cite journal |vauthors=Versura P, Frigato M, Cellini M, Mulè R, Malavolta N, Campos EC |title=Diagnostic performance of tear function tests in Sjogren's syndrome patients |journal=Eye (Lond) |volume=21 |issue=2 |pages=229–37 |date=February 2007 |pmid=16397619 |doi=10.1038/sj.eye.6702204 |url=}}</ref><ref name="pmid18599017">{{cite journal |vauthors=Lemp MA |title=Advances in understanding and managing dry eye disease |journal=Am. J. Ophthalmol. |volume=146 |issue=3 |pages=350–356 |date=September 2008 |pmid=18599017 |doi=10.1016/j.ajo.2008.05.016 |url=}}</ref>
OR
*Physical examination of patients with [disease name] is usually remarkable for:[finding 1], [finding 2], and [finding 3].
*The presence of [finding(s)] on physical examination is diagnostic of [disease name].
*The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
 
===Appearance of the Patient===
===Appearance of the Patient===
*Patients with [disease name] usually appear [general appearance].  
*Patients with Sjögren's syndrome usually appear good.


===Vital Signs===
===Vital Signs===
 
*Vital sign might be normal.
*High-grade / low-grade fever
*[[Hypothermia]] / hyperthermia may be present
*[[Tachycardia]] with regular pulse or (ir)regularly irregular pulse
*[[Bradycardia]] with regular pulse or (ir)regularly irregular pulse
*Tachypnea / bradypnea
*Kussmal respirations may be present in _____ (advanced disease state)
*Weak/bounding pulse / pulsus alternans / paradoxical pulse / asymmetric pulse
*High/low blood pressure with normal pulse pressure / [[wide pulse pressure]] / [[narrow pulse pressure]]


===Skin===
===Skin===
* Skin examination of patients with [disease name] is usually normal.
*Dryness
OR
*[[Scaling skin|Scaling]]
*[[Cyanosis]]  
*Partial or complete loss of [[sweating]]
*[[Jaundice]]
*Dry, sparse, and brittle hair
* [[Pallor]]
*Diffuse [[alopecia]] may involve the [[scalp]], [[Limb (anatomy)|limbs]], [[axilla]], or [[pubis]]
* Bruises
*Nail folds may show capillaroscopic abnormalities
 
*Nonpalpable or palpable, vasculitic [[purpura]], 2-3 mm lesions on the [[Human leg|lower extremities]]
<gallery widths="150px">
*Annular [[erythema]] with scales on the face and neck
 
UploadedImage-01.jpg | Description {{dermref}}
UploadedImage-02.jpg | Description {{dermref}}
 
</gallery>


===HEENT===
===HEENT===
*Mucous dryness
*[[Mucus|Mucous]] dryness
*Tongue - Red, smooth, and dry  
*Red, smooth, and dry [[tongue]]
*Dental caries
*Hyperlobulated [[tongue]] with loss of filiform [[Papilla|papillae]]
*Parotid duct narrowing
*Absence of salivary pooling under the [[tongue]]
*Lips - Red, dry, and scaly
*[[Dental caries]]
*[[Gingiva|Gingival]] inflammation
*Red, dry, and scaly lips
*Cracks at the corners of the mouth
*Cracks at the corners of the mouth
*Chronic oral candidiasis
*Chronic [[oral]] [[candidiasis]]


===Neck===
===Neck===
* Neck examination of patients with [disease name] is usually normal.
*Bilateral [[parotid gland enlargement]]
OR
*[[Jugular venous distension]]
*[[Carotid bruits]] may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope
*[[Lymphadenopathy]] (describe location, size, tenderness, mobility, and symmetry)
*[[Thyromegaly]] / thyroid nodules
*[[Hepatojugular reflux]]


===Lungs===
===Lungs===
* Pulmonary examination of patients with [disease name] is usually normal.
*Bibasilar [[rales]]  
OR
* Asymmetric chest expansion / Decreased chest expansion
*Lungs are hypo/hyperresonant
*Fine/coarse [[crackles]] upon auscultation of the lung bases/apices unilaterally/bilaterally
*Rhonchi
*Vesicular breath sounds / Distant breath sounds
*Expiratory/inspiratory wheezing with normal / delayed expiratory phase
*[[Wheezing]] may be present
*[[Wheezing]] may be present
*[[Egophony]] present/absent
*[[Bronchophony]] present/absent
*Normal/reduced [[tactile fremitus]]


===Heart===
===Heart===
* Cardiovascular examination of patients with [disease name] is usually normal.
* Cardiovascular examination of patients with Sjögren's syndrome is usually normal.
OR
*Chest tenderness upon palpation
*PMI within 2 cm of the sternum  (PMI) / Displaced point of maximal impulse (PMI) suggestive of ____
*[[Heave]] / [[thrill]]
*[[Friction rub]]
*[[Heart sounds#First heart tone S1, the "lub"(components M1 and T1)|S1]]
*[[Heart sounds#Second heart tone S2 the "dub"(components A2 and P2)|S2]]
*[[Heart sounds#Third heart sound S3|S3]]
*[[Heart sounds#Fourth heart sound S4|S4]]
*[[Heart sounds#Summation Gallop|Gallops]]
*A high/low grade early/late [[systolic murmur]] / [[diastolic murmur]] best heard at the base/apex/(specific valve region) may be heard using the bell/diaphgram of the otoscope


===Abdomen===
===Abdomen===
Abdominal examination of patients with [disease name] is usually normal.
*[[Splenomegaly]]
 
OR
*[[Abdominal distention]]
*[[Abdominal tenderness]] in the right/left upper/lower abdominal quadrant
*[[Rebound tenderness]] (positive Blumberg sign)
*A palpable abdominal mass in the right/left upper/lower abdominal quadrant
*Guarding may be present
*[[Hepatomegaly]] / [[splenomegaly]] / [[hepatosplenomegaly]]
*Additional findings, such as obturator test, psoas test, McBurney point test, Murphy test


===Back===
===Back===
* Back examination of patients with [disease name] is usually normal.
* Back examination of patients with Sjögren's syndrome is usually normal.
OR
*Point tenderness over __ vertebrae (e.g. L3-L4)
*Sacral edema
*Costovertebral angle tenderness bilaterally/unilaterally
*Buffalo hump


===Genitourinary===
===Genitourinary===
* Genitourinary examination of patients with [disease name] is usually normal.
*Irritated [[bladder]]
OR
*Suprapubic [[tenderness]]
*A pelvic/adnexal mass may be palpated
*Atrophic changes in the [[vulva]] and [[Vagina|vagin]]
*Inflamed mucosa
*Dryness of the [[anal]] and [[rectal]] [[mucous membranes]]
*Clear/(color), foul-smelling/odorless penile/vaginal discharge


===Neuromuscular===
===Neuromuscular===
* Neuromuscular examination of patients with [disease name] is usually normal.
*Patient is usually oriented to persons, place, and time.
OR
*Glasgow coma scale is 15/15
*Patient is usually oriented to persons, place, and time
*[[Paraparesis]] maybe present  
* Altered mental status
*[[Paraplegia]] may be present
* Glasgow coma scale is ___ / 15
* Clonus may be present
* Hyperreflexia / hyporeflexia / areflexia
* Positive (abnormal) Babinski / plantar reflex unilaterally/bilaterally
* Muscle rigidity
* Proximal/distal muscle weakness unilaterally/bilaterally
* ____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
*Unilateral/bilateral upper/lower extremity weakness
*Unilateral/bilateral sensory loss in the upper/lower extremity
*Positive straight leg raise test
*Abnormal gait (describe gait: e.g. ataxic (cerebellar) gait / steppage gait / waddling gait / choeiform gait / Parkinsonian gait / sensory gait)
*Positive/negative Trendelenburg sign
*Unilateral/bilateral tremor (describe tremor, e.g. at rest, pill-rolling)
*Normal finger-to-nose test / Dysmetria
*Absent/present dysdiadochokinesia (palm tapping test)


===Extremities===
===Extremities===
* Extremities examination of patients with [disease name] is usually normal.
*Symmetrical, polyarticular, [[inflammatory arthritis]]
OR
*[[Clubbing]]
*[[Cyanosis]]
*Pitting/non-pitting [[edema]] of the upper/lower extremities
*Muscle atrophy
*Fasciculations in the upper/lower extremity
 


==References==
==References==
{{reflist|2}}
{{reflist|2}}


[[Category:Medicine]]
[[Category:Immunology]]
[[Category:Rheumatology]]
[[Category:Rheumatology]]
[[Category:Immunology]]
[[Category:Up-To-Date]]
 
{{WS}}
{{WH}}

Latest revision as of 00:12, 30 July 2020

Sjögren's syndrome Microchapters

Home

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Sjögren's syndrome from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

Echocardiography and Ultrasound

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Sjögren's syndrome physical examination On the Web

Most recent articles

cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Sjögren's syndrome physical examination

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Sjögren's syndrome physical examination

CDC on Sjögren's syndrome physical examination

Sjögren's syndrome physical examination in the news

Blogs on Sjögren's syndrome physical examination

Directions to Hospitals Treating Sjögren's syndrome

Risk calculators and risk factors for Sjögren's syndrome physical examination

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

Overview

Physical examination of patients with is usually remarkable for dryness of all mucous membranes such as mouth, eyes, lips, anal and rectal.

Physical Examination

Appearance of the Patient

  • Patients with Sjögren's syndrome usually appear good.

Vital Signs

  • Vital sign might be normal.

Skin

HEENT

Neck

Lungs

Heart

  • Cardiovascular examination of patients with Sjögren's syndrome is usually normal.

Abdomen

Back

  • Back examination of patients with Sjögren's syndrome is usually normal.

Genitourinary

Neuromuscular

  • Patient is usually oriented to persons, place, and time.
  • Glasgow coma scale is 15/15
  • Paraparesis maybe present
  • Paraplegia may be present

Extremities

References

  1. ↑ Lopate G, Pestronk A, Al-Lozi M, Lynch T, Florence J, Miller T, Levine T, Rampy T, Beson B, Ramneantu I (May 2006). "Peripheral neuropathy in an outpatient cohort of patients with Sjögren's syndrome". Muscle Nerve. 33 (5): 672–6. doi:10.1002/mus.20514. PMID 16453296.
  2. ↑ Antoniazzi RP, Miranda LA, Zanatta FB, Islabão AG, Gustafsson A, Chiapinotto GA, Oppermann RV (March 2009). "Periodontal conditions of individuals with Sjögren's syndrome". J. Periodontol. 80 (3): 429–35. doi:10.1902/jop.2009.080350. PMID 19254127.
  3. ↑ Riccieri V, Sciarra I, Ceccarelli F, Alessandri C, Croia C, Vasile M, Modesti MG, Priori R, Valesini G (June 2009). "Nailfold capillaroscopy abnormalities are associated with the presence of anti-endothelial cell antibodies in Sjogren's syndrome". Rheumatology (Oxford). 48 (6): 704–6. doi:10.1093/rheumatology/kep051. PMID 19307256.
  4. ↑ Ren H, Wang WM, Chen XN, Zhang W, Pan XX, Wang XL, Lin Y, Zhang S, Chen N (February 2008). "Renal involvement and followup of 130 patients with primary Sjögren's syndrome". J. Rheumatol. 35 (2): 278–84. PMID 18085734.
  5. ↑ Versura P, Frigato M, Cellini M, Mulè R, Malavolta N, Campos EC (February 2007). "Diagnostic performance of tear function tests in Sjogren's syndrome patients". Eye (Lond). 21 (2): 229–37. doi:10.1038/sj.eye.6702204. PMID 16397619.
  6. ↑ Lemp MA (September 2008). "Advances in understanding and managing dry eye disease". Am. J. Ophthalmol. 146 (3): 350–356. doi:10.1016/j.ajo.2008.05.016. PMID 18599017.
Retrieved from "https://www.wikidoc.org/index.php?title=Sjögren%27s_syndrome_physical_examination&oldid=1643375"