Rheumatoid arthritis physical examination: Difference between revisions
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==Overview== | ==Overview== | ||
Patients with rheumatoid arthritis usually appear fatigued. On skin examination, [[Rheumatoid nodule|rheumatoid nodules]], [[erythema nodosum]], [[atrophy]] of the digital skin, [[palmar erythema]], and diffuse thinning of the skin may be found. If there is involvement of the eyes, [[scleritis]] and [[scleromalacia]] may be seen. On auscultation of lungs, decreased breath sounds on both sides and [[crackles]] may be observed. On palpation of the abdomen, [[hepatomegaly]] and [[splenomegaly]] is usually found when it is associated with [[Felty's syndrome]]. On examination of extremities, [[redness]], and swelling of the affected joints, [[tenderness]], pain on movement and decreased the range of movement is usually found. | |||
==Physical examination== | ==Physical examination== | ||
===Appearance of the Patient=== | |||
* | *Patients with rheumatoid arthritis usually appear fatigued. | ||
===Vital Signs=== | |||
*[[Low-grade fever]] | |||
====Skin==== | ====Skin==== | ||
*Rheumatoid nodule found over bony prominences, such as the [[olecranon]], the [[Calcaneus#Calcaneal_tuberosity|calcaneal tuberosity]], the [[metacarpophalangeal joint]]s, or other areas that sustain repeated mechanical stress | *Rheumatoid nodule found over bony prominences, such as the [[olecranon]], the [[Calcaneus#Calcaneal_tuberosity|calcaneal tuberosity]], the [[metacarpophalangeal joint]]s, or other areas that sustain repeated mechanical stress <ref name="pmid15850993">{{cite journal |vauthors=Pham T, Gossec L, Fautrel B, Combe B, Flipo RM, Goupille P, Le Loët X, Mariette X, Puéchal X, Wendling D, Schaeverbeke T, Sibilia J, Sany J, Dougados M |title=Physical examination and laboratory tests in the management of patients with rheumatoid arthritis: development of recommendations for clinical practice based on published evidence and expert opinion |journal=Joint Bone Spine |volume=72 |issue=3 |pages=222–8 |date=May 2005 |pmid=15850993 |doi=10.1016/j.jbspin.2004.10.010 |url=}}</ref> <ref name="pmid29464524">{{cite journal |vauthors=Medina YF, Ruíz-Gaviria RE, Buitrago-Lopez A, Villota C |title=Physical articular examination in the activity of rheumatoid arthritis: a systematic review of the literature : Systematic review of the literature regarding physical examination in rheumatoid arthritis |journal=Clin. Rheumatol. |volume= |issue= |pages= |date=February 2018 |pmid=29464524 |doi=10.1007/s10067-018-4015-4 |url=}}</ref> | ||
*[[Erythema nodosum]] | *[[Erythema nodosum]] | ||
*[[Atrophy]] of digital skin | *[[Atrophy]] of digital skin | ||
*[[Palmar erythema]] | *[[Palmar erythema]] | ||
*Diffuse thinning (rice paper skin), and | *Diffuse thinning (rice paper skin), and of | ||
*Beading on the nails | *Beading on the nails | ||
| Line 33: | Line 36: | ||
==== Extremities ==== | ==== Extremities ==== | ||
On inspection redness and swelling of the affected joints. | *On inspection redness and swelling of the affected joints. | ||
On palpation: | *On palpation: | ||
*Tenderness | **Tenderness | ||
*Pain on movement | **Pain on movement | ||
*Decreased range of movement | **Decreased range of movement | ||
==References== | ==References== | ||
Latest revision as of 20:57, 20 April 2018
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Rheumatoid arthritis physical examination On the Web | |
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Risk calculators and risk factors for Rheumatoid arthritis physical examination | |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2]
Overview
Patients with rheumatoid arthritis usually appear fatigued. On skin examination, rheumatoid nodules, erythema nodosum, atrophy of the digital skin, palmar erythema, and diffuse thinning of the skin may be found. If there is involvement of the eyes, scleritis and scleromalacia may be seen. On auscultation of lungs, decreased breath sounds on both sides and crackles may be observed. On palpation of the abdomen, hepatomegaly and splenomegaly is usually found when it is associated with Felty's syndrome. On examination of extremities, redness, and swelling of the affected joints, tenderness, pain on movement and decreased the range of movement is usually found.
Physical examination
Appearance of the Patient
- Patients with rheumatoid arthritis usually appear fatigued.
Vital Signs
Skin
- Rheumatoid nodule found over bony prominences, such as the olecranon, the calcaneal tuberosity, the metacarpophalangeal joints, or other areas that sustain repeated mechanical stress [1] [2]
- Erythema nodosum
- Atrophy of digital skin
- Palmar erythema
- Diffuse thinning (rice paper skin), and of
- Beading on the nails
Eyes
- Dry eyes
- Scleritis
- Scleromalacia
Lungs
On Auscultation of lungs:
- Decreased breath sounds on both sides.
- Crackles may be present.
Abdomen
- On palpation:
Extremities
- On inspection redness and swelling of the affected joints.
- On palpation:
- Tenderness
- Pain on movement
- Decreased range of movement
References
- ↑ Pham T, Gossec L, Fautrel B, Combe B, Flipo RM, Goupille P, Le Loët X, Mariette X, Puéchal X, Wendling D, Schaeverbeke T, Sibilia J, Sany J, Dougados M (May 2005). "Physical examination and laboratory tests in the management of patients with rheumatoid arthritis: development of recommendations for clinical practice based on published evidence and expert opinion". Joint Bone Spine. 72 (3): 222–8. doi:10.1016/j.jbspin.2004.10.010. PMID 15850993.
- ↑ Medina YF, Ruíz-Gaviria RE, Buitrago-Lopez A, Villota C (February 2018). "Physical articular examination in the activity of rheumatoid arthritis: a systematic review of the literature : Systematic review of the literature regarding physical examination in rheumatoid arthritis". Clin. Rheumatol. doi:10.1007/s10067-018-4015-4. PMID 29464524.