Hydronephrosis physical examination: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Hydronephrosis}} | {{Hydronephrosis}} | ||
{{CMG}} | {{CMG}}[[hydronephrosis]]; {{AE}} {{VKG}} | ||
==Overview== | ==Overview== | ||
Patients with [[hydronephrosis]]<nowiki/>complain presence of pain based on the site of the obstruction and the degree of the obstruction. Patients commonly present with [[abdominal distension]], [[palpable]] kidney, [[Costovertebral angle|costovertebral]] tenderness and palpable [[bladder]] may be seen. | |||
==Physical Examination== | ==Physical Examination== | ||
Physical examination of patients with [[hydronephrosis]]<nowiki/>is usually remarkable for [[abdominal distension]], [[palpable]] kidney, [[Costovertebral angle|costovertebral]] tenderness and palpable [[bladder]]. The appearance of the patients with [[hydronephrosis]] usually appear normal.<ref name="pmid12809872">{{cite journal |vauthors=Lam JS, Cooper KL, Greene TD, Gupta M |title=Impact of hydronephrosis and renal function on treatment outcome: antegrade versus retrograde endopyelotomy |journal=Urology |volume=61 |issue=6 |pages=1107–11; discussion 1111–2 |date=June 2003 |pmid=12809872 |doi= |url=}}</ref> | |||
=== Vital Signs === | |||
* High-grade / low-grade [[fever]] when positive for infection. | |||
* [[Tachycardia]] with a regular pulse because of the fever which is due to infection. | |||
* [[High blood pressure]] due to salt retention. | |||
===Skin=== | |||
* Skin examination of patients with [[hydronephrosis]]<nowiki/>is usually normal. | |||
===HEENT=== | |||
* HEENT examination of patients with [[hydronephrosis]]<nowiki/>is usually unremarkable. | |||
===Neck=== | |||
* Neck examination of patients with [[hydronephrosis]]<nowiki/>is usually normal. | |||
===Lungs=== | |||
* [[Pulmonary]] examination of patients with [[hydronephrosis]]<nowiki/>is usually normal. | |||
===Heart=== | |||
* [[Cardiovascular]] examination of patients with [[hydronephrosis]] is usually normal. | |||
===Abdomen=== | ===Abdomen=== | ||
* | * Suprapubic tenderness (with or without a history of [[Urinary bladder|bladder]] outflow obstruction) along with a [[palpable]] bladder are strongly suggestive of [[Acute (medical)|acute]] [[urine|urinary]] [[retention]], which left untreated is highly likely to cause hydronephrosis | ||
* Upper urinary tract obstruction is characterised by pain in the [[flank]], often radiating to either the [[abdomen]] or the [[groin]] | * Upper urinary tract obstruction is characterised by pain in the [[flank]], often radiating to either the [[abdomen]] or the [[groin]] | ||
* Where the [[obstruction]] is [[chronic (medicine)|chronic]], [[renal failure]] may also be present. If the obstruction is complete, an enlarged kidney is often [[palpable]] on examination | |||
*[[Abdominal distention]]. | |||
*A [[palpable]] distended bladder is noted | |||
*[[Kidney]] may be palpable in some cases | |||
===Back=== | |||
*[[Costovertebral angle|Costovertebral]] angle [[tenderness]] on the affected side is seen | |||
===Genitourinary=== | |||
*[[Rectal]] examination should be performed in patients with [[hydronephrosis]] to assess | |||
**[[Sphincter]] tone | |||
**[[Prostate]] | |||
===Neuromuscular=== | |||
* [[Neuromuscular]] examination of patients with [[hydronephrosis]] is usually normal. | |||
===Extremities=== | |||
*lower extremity [[edema]] may occur when [[hydronephrosis]] is [[bilateral]]. | |||
==References== | ==References== | ||
Latest revision as of 18:13, 12 August 2018
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Hydronephrosis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Hydronephrosis physical examination On the Web |
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American Roentgen Ray Society Images of Hydronephrosis physical examination |
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Risk calculators and risk factors for Hydronephrosis physical examination |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]hydronephrosis; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]
Overview
Patients with hydronephrosiscomplain presence of pain based on the site of the obstruction and the degree of the obstruction. Patients commonly present with abdominal distension, palpable kidney, costovertebral tenderness and palpable bladder may be seen.
Physical Examination
Physical examination of patients with hydronephrosisis usually remarkable for abdominal distension, palpable kidney, costovertebral tenderness and palpable bladder. The appearance of the patients with hydronephrosis usually appear normal.[1]
Vital Signs
- High-grade / low-grade fever when positive for infection.
- Tachycardia with a regular pulse because of the fever which is due to infection.
- High blood pressure due to salt retention.
Skin
- Skin examination of patients with hydronephrosisis usually normal.
HEENT
- HEENT examination of patients with hydronephrosisis usually unremarkable.
Neck
- Neck examination of patients with hydronephrosisis usually normal.
Lungs
- Pulmonary examination of patients with hydronephrosisis usually normal.
Heart
- Cardiovascular examination of patients with hydronephrosis is usually normal.
Abdomen
- Suprapubic tenderness (with or without a history of bladder outflow obstruction) along with a palpable bladder are strongly suggestive of acute urinary retention, which left untreated is highly likely to cause hydronephrosis
- Upper urinary tract obstruction is characterised by pain in the flank, often radiating to either the abdomen or the groin
- Where the obstruction is chronic, renal failure may also be present. If the obstruction is complete, an enlarged kidney is often palpable on examination
- Abdominal distention.
- A palpable distended bladder is noted
- Kidney may be palpable in some cases
Back
- Costovertebral angle tenderness on the affected side is seen
Genitourinary
- Rectal examination should be performed in patients with hydronephrosis to assess
Neuromuscular
- Neuromuscular examination of patients with hydronephrosis is usually normal.
Extremities
- lower extremity edema may occur when hydronephrosis is bilateral.