Polyarteritis nodosa physical examination: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
 
(4 intermediate revisions by the same user not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Polyarteritis nodosa}}
{{Polyarteritis nodosa}}
{{CMG}}; {{AE}} {{CZ}}; [[User:Haritha|Haritha Machavarapu, M.B.B.S.]]
* {{CMG}}; {{AE}} {{SSW}}


==Overview==
== Overview ==
Physical examination plays an important role in diagnosing polyarteritis nodosa. Arteritis can be suspected with the presence of multiple [[Mononeuropathy|mononeuropathies]].Signs of ischemia such as extremity ischemia, hypertension and renovascular disease can help in diagnosing polyarteritis nodosa. Skin examination of patients with polyarteritis nodosa can show [[Livedo reticularis|Livedo]] [[Livedo reticularis|reticularis]], ulceration, digital ischemia, and nodules. Polyarteritis nodosa may present with ophthalmologic symptoms like retinal vasculitis, retinal detachment and cotton-wool spots. Cardiovascular examination of patients with polyarteritis nodosa shows hypertension, tachycardia, pericardial friction rub, arrhythmias and congestive heart failure. Abdominal examination of patients with polyarteritis nodosa shows abdominal tenderness and gastro-intestinal bleeding. Neuromuscular examination of patients with polyarteritis nodosa shows sensory and/or motor neuropathies and mononeuritis multiplex.


==Physical Examination==
== Physical Examination ==
* Physical examination plays an important role in diagnosing PAN.  
* Physical examination plays an important role in diagnosing polyarteritis nodosa.  
* Arteritis can be suspected with the presence of multiple mononeuropathies.  
* Arteritis can be suspected with the presence of multiple [[Mononeuropathy|mononeuropathies]].  
* Signs of ischemia such as extremity ischemia, hypertension and renovascular disease can help in diagnosing PAN.  
* Signs of ischemia such as extremity ischemia, hypertension and renovascular disease can help in diagnosing polyarteritis nodosa.  


=== Skin ===
=== Skin ===
* Skin examination of patients with PAN can show:
* Skin examination of patients with polyarteritis nodosa can show:<ref name="pmid12350194">{{cite journal |vauthors=Stone JH |title=Polyarteritis nodosa |journal=JAMA |volume=288 |issue=13 |pages=1632–9 |date=October 2002 |pmid=12350194 |doi= |url=}}</ref>
** [[Livedo reticularis]]
** [[Livedo reticularis]]
** [[Ulcer|Ulcerations]]  
** [[Ulcer|Ulcerations]]  
Line 20: Line 21:
** Nodules
** Nodules
*** Nodules are a rare finding.  
*** Nodules are a rare finding.  
*** Most commonly seen on lower extremity.   Cutaneous symptoms in PAN include the following<sup> [[null 6]] </sup>(see the images below):
*** Most commonly seen on lower extremity.
**** Livedo reticularis that does not blanch with active pressure
 
**** Ulcerations - Especially on the lower extremities, near the malleoli and on the calf
=== HEENT ===
**** Digital ischemia - May be accompanied by splinter hemorrhages and, sometimes, gangrene
* Polyarteritis nodosa may present with ophthalmologic symptoms like:
**** Nodules - Usually on the lower extremities (like ulcers); nodules are the least common skin manifestation of PAN
** Retinal vasculitis
** Retinal detachment
** Cotton-wool spots
 
=== Heart ===
* Cardiovascular examination of patients with polyarteritis nodosa shows:
** Hypertension
** Tachycardia
** Pericardial friction rub
** Arrhythmias
** Congestive heart failure
 
=== Abdomen ===
* Abdominal examination of patients with polyarteritis nodosa shows:<ref name="pmid11904113">{{cite journal |vauthors=Levine SM, Hellmann DB, Stone JH |title=Gastrointestinal involvement in polyarteritis nodosa (1986-2000): presentation and outcomes in 24 patients |journal=Am. J. Med. |volume=112 |issue=5 |pages=386–91 |date=April 2002 |pmid=11904113 |doi= |url=}}</ref>
** Abdominal tenderness
** Gastro-intestinal bleeding
 
=== Genitourinary ===
* Genitourinary examination of patients with polyarteritis nodosa reveals testicular tenderness on palpation.
 
=== Neuromuscular ===
* Neuromuscular examination of patients with polyarteritis nodosa shows:<ref name="pmid1979706">{{cite journal |vauthors=Rosenberg MR, Parshley M, Gibson S, Wernick R |title=Central nervous system polyarteritis nodosa |journal=West. J. Med. |volume=153 |issue=5 |pages=553–6 |date=November 1990 |pmid=1979706 |pmc=1002622 |doi= |url=}}</ref>
** Sensory and/or motor neuropathies
** Mononeuritis multiplex<ref name="pmid11723762">{{cite journal |vauthors=Griffin JW |title=Vasculitic neuropathies |journal=Rheum. Dis. Clin. North Am. |volume=27 |issue=4 |pages=751–60, vi |date=November 2001 |pmid=11723762 |doi= |url=}}</ref>
*** Asymmetrical
*** Nerves that are usually involved include: ulnar, radial,peroneal etc.


==References==
==References==

Latest revision as of 17:26, 21 May 2018

Polyarteritis nodosa Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Polyarteritis nodosa from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiography

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

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

Polyarteritis nodosa physical examination On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Polyarteritis nodosa 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 Polyarteritis nodosa physical examination

CDC on Polyarteritis nodosa physical examination

Polyarteritis nodosa physical examination in the news

Blogs on Polyarteritis nodosa physical examination

Directions to Hospitals Treating Polyarteritis nodosa

Risk calculators and risk factors for Polyarteritis nodosa physical examination

Overview

Physical examination plays an important role in diagnosing polyarteritis nodosa. Arteritis can be suspected with the presence of multiple mononeuropathies.Signs of ischemia such as extremity ischemia, hypertension and renovascular disease can help in diagnosing polyarteritis nodosa. Skin examination of patients with polyarteritis nodosa can show Livedo reticularis, ulceration, digital ischemia, and nodules. Polyarteritis nodosa may present with ophthalmologic symptoms like retinal vasculitis, retinal detachment and cotton-wool spots. Cardiovascular examination of patients with polyarteritis nodosa shows hypertension, tachycardia, pericardial friction rub, arrhythmias and congestive heart failure. Abdominal examination of patients with polyarteritis nodosa shows abdominal tenderness and gastro-intestinal bleeding. Neuromuscular examination of patients with polyarteritis nodosa shows sensory and/or motor neuropathies and mononeuritis multiplex.

Physical Examination

  • Physical examination plays an important role in diagnosing polyarteritis nodosa.
  • Arteritis can be suspected with the presence of multiple mononeuropathies.
  • Signs of ischemia such as extremity ischemia, hypertension and renovascular disease can help in diagnosing polyarteritis nodosa.

Skin

  • Skin examination of patients with polyarteritis nodosa can show:[1]
    • Livedo reticularis
    • Ulcerations
      • Ulcers can be seen on the lower extremeties
    • Digital ischemia
      • Splinter hemorrages can be seen.
      • Gangrene can also be seen.
    • Nodules
      • Nodules are a rare finding.
      • Most commonly seen on lower extremity.

HEENT

  • Polyarteritis nodosa may present with ophthalmologic symptoms like:
    • Retinal vasculitis
    • Retinal detachment
    • Cotton-wool spots

Heart

  • Cardiovascular examination of patients with polyarteritis nodosa shows:
    • Hypertension
    • Tachycardia
    • Pericardial friction rub
    • Arrhythmias
    • Congestive heart failure

Abdomen

  • Abdominal examination of patients with polyarteritis nodosa shows:[2]
    • Abdominal tenderness
    • Gastro-intestinal bleeding

Genitourinary

  • Genitourinary examination of patients with polyarteritis nodosa reveals testicular tenderness on palpation.

Neuromuscular

  • Neuromuscular examination of patients with polyarteritis nodosa shows:[3]
    • Sensory and/or motor neuropathies
    • Mononeuritis multiplex[4]
      • Asymmetrical
      • Nerves that are usually involved include: ulnar, radial,peroneal etc.

References

  1. ↑ Stone JH (October 2002). "Polyarteritis nodosa". JAMA. 288 (13): 1632–9. PMID 12350194.
  2. ↑ Levine SM, Hellmann DB, Stone JH (April 2002). "Gastrointestinal involvement in polyarteritis nodosa (1986-2000): presentation and outcomes in 24 patients". Am. J. Med. 112 (5): 386–91. PMID 11904113.
  3. ↑ Rosenberg MR, Parshley M, Gibson S, Wernick R (November 1990). "Central nervous system polyarteritis nodosa". West. J. Med. 153 (5): 553–6. PMC 1002622. PMID 1979706.
  4. ↑ Griffin JW (November 2001). "Vasculitic neuropathies". Rheum. Dis. Clin. North Am. 27 (4): 751–60, vi. PMID 11723762.

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Polyarteritis_nodosa_physical_examination&oldid=1472129"