Amyloidosis physical examination: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Amyloidosis}} | {{Amyloidosis}} | ||
{{CMG}} | {{CMG}}; {{AE}} {{JH}} | ||
== Overview == | == Overview == | ||
Common findings in amyloidosis include [[ | Common findings in amyloidosis include waxy thickening, [[easy bruising]], [[purpura]], macroglossia, [[parotid gland]] and [[submandibular gland]] enlargement, [[edema]], [[numbness]] and [[paresthesia]]. | ||
==Physical Examination== | ==Physical Examination== | ||
=== | [[Physical examination]] of patients with amyloidosis is usually remarkable for waxy thickening, [[easy bruising]], [[purpura]], [[macroglossia]], [[parotid gland]] and [[submandibular gland]] enlargement, [[edema]], [[numbness]] and [[paresthesia]].<ref name="pmid267192344">{{cite journal |vauthors=Wechalekar AD, Gillmore JD, Hawkins PN |title=Systemic amyloidosis |journal=Lancet |volume=387 |issue=10038 |pages=2641–2654 |date=June 2016 |pmid=26719234 |doi=10.1016/S0140-6736(15)01274-X |url=}}</ref><ref name="pmid14660909">{{cite journal |vauthors=Pribitkin E, Friedman O, O'Hara B, Cunnane MF, Levi D, Rosen M, Keane WM, Sataloff RT |title=Amyloidosis of the upper aerodigestive tract |journal=Laryngoscope |volume=113 |issue=12 |pages=2095–101 |date=December 2003 |pmid=14660909 |doi=10.1097/00005537-200312000-00007 |url=}}</ref><ref name="pmid23239211">{{cite journal |vauthors=Shin SC, Robinson-Papp J |title=Amyloid neuropathies |journal=Mt. Sinai J. Med. |volume=79 |issue=6 |pages=733–48 |date=2012 |pmid=23239211 |pmc=3531896 |doi=10.1002/msj.21352 |url=}}</ref><br /> | ||
===Appearance of the Patient=== | |||
*Patients with amyloidosis usually appear normal. | |||
===Vital signs=== | |||
* [[Hypertension]] | * [[Hypertension]] | ||
* [[Tachycardia]] | * [[Tachycardia]] | ||
===Skin=== | |||
*Waxy thickening | |||
*Easy bruising (ecchymoses) | |||
*Subcutaneous [[nodules]] or [[plaques]] | |||
*[[Purpura]] | |||
* [[Petechiae]] | |||
* Brittle nails | |||
*[[Edema]] | |||
*Diffuse or patchy [[alopecia]] | |||
*Nail dystrophy | |||
*Brittle nails | |||
===HEENT=== | |||
*[[Macroglossia]] | |||
*[[Parotid gland]] enlargement | |||
*[[Submandibular gland]] enlargement | |||
*Peri-orbital [[purpura]] | |||
* Raised [[intraocular pressure]] may be seen. | |||
*Visual and hearing loss may be seen. | |||
<gallery> | |||
Image:Amyloidosis_01.jpeg|Amyloidosis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=27> | |||
=== | Image:Amyloidosis_02.jpeg|Amyloidosis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=27> | ||
Image:Amyloidosis_03.jpeg|Amyloidosis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=27> | |||
Image:Amyloidosis_04.jpeg|Amyloidosis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=27> | |||
Image:Amyloidosis_05.jpeg|Amyloidosis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=27> | |||
Image:Amyloidosis_06.jpeg|Amyloidosis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=27> | |||
Image:Amyloidosis_07.jpeg|Amyloidosis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=27> | |||
</gallery> | |||
=== | ===Neck=== | ||
* | * Neck examination of patients with amyloidosis is usually normal. | ||
=== | ===Lungs=== | ||
* | *[[Hoarseness]] | ||
*[[Stridor]] | |||
*[[Dysphagia]] | |||
=== | ===Heart=== | ||
* [[ | *[[Arrhythmia]] | ||
===Abdomen=== | ===Abdomen=== | ||
* [[Hepatomegaly]] | * [[Hepatomegaly]] | ||
===Back=== | |||
* Back examination of patients with amyloidosis is usually normal. | |||
===Genitourinary=== | |||
*[[Genitourinary]] examination of patients with amyloidosis is usually normal. | |||
===Neuromuscular=== | |||
*[[Numbness]] | |||
*[[Paresthesia]] | |||
*Pain | |||
===Extremities=== | ===Extremities=== | ||
*[[Edema]] | |||
* [[Carpal tunnel syndrome]] | * [[Carpal tunnel syndrome]] | ||
* [[Numbness]] of the fingers and toes | * [[Numbness]] of the fingers and toes | ||
* [[Raynaud phenomenon]] | * [[Raynaud phenomenon]] | ||
===Macular Amyloidosis=== | |||
<gallery widths="130px"> | |||
291.jpg | Macular Amyloidosis <br> [http://www.atlasdermatologico.com.br <font size="-2">''Adapted from Dermatology Atlas''</font>] | |||
292.jpg | Macular Amyloidosis <br> [http://www.atlasdermatologico.com.br <font size="-2">''Adapted from Dermatology Atlas''</font>] | |||
293.jpg | Macular Amyloidosis <br> [http://www.atlasdermatologico.com.br <font size="-2">''Adapted from Dermatology Atlas''</font>] | |||
294.jpg | Macular Amyloidosis <br> [http://www.atlasdermatologico.com.br <font size="-2">''Adapted from Dermatology Atlas''</font>] | |||
295.jpg | Macular Amyloidosis <br> [http://www.atlasdermatologico.com.br <font size="-2">''Adapted from Dermatology Atlas''</font>] | |||
</gallery> | |||
===Nodular Amyloidosis=== | |||
<gallery widths="130px"> | |||
297.jpg | Nodular Amyloidosis <br> [http://www.atlasdermatologico.com.br <font size="-2">''Adapted from Dermatology Atlas''</font>] | |||
300.jpg | Nodular Amyloidosis <br> [http://www.atlasdermatologico.com.br <font size="-2">''Adapted from Dermatology Atlas''</font>] | |||
302.jpg | Nodular Amyloidosis <br> [http://www.atlasdermatologico.com.br <font size="-2">''Adapted from Dermatology Atlas''</font>] | |||
307.jpg | Nodular Amyloidosis <br> [http://www.atlasdermatologico.com.br <font size="-2">''Adapted from Dermatology Atlas''</font>] | |||
</gallery> | |||
== References == | == References == | ||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Rheumatology]] | [[Category:Rheumatology]] | ||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Endocrinology]] | [[Category:Endocrinology]] | ||
{{WH}} | |||
{{WS}} |
Latest revision as of 21:19, 17 December 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jesus Rosario Hernandez, M.D. [2]
Overview
Common findings in amyloidosis include waxy thickening, easy bruising, purpura, macroglossia, parotid gland and submandibular gland enlargement, edema, numbness and paresthesia.
Physical Examination
Physical examination of patients with amyloidosis is usually remarkable for waxy thickening, easy bruising, purpura, macroglossia, parotid gland and submandibular gland enlargement, edema, numbness and paresthesia.[1][2][3]
Appearance of the Patient
- Patients with amyloidosis usually appear normal.
Vital signs
Skin
- Waxy thickening
- Easy bruising (ecchymoses)
- Subcutaneous nodules or plaques
- Purpura
- Petechiae
- Brittle nails
- Edema
- Diffuse or patchy alopecia
- Nail dystrophy
- Brittle nails
HEENT
- Macroglossia
- Parotid gland enlargement
- Submandibular gland enlargement
- Peri-orbital purpura
- Raised intraocular pressure may be seen.
- Visual and hearing loss may be seen.
Neck
- Neck examination of patients with amyloidosis is usually normal.
Lungs
Heart
Abdomen
Back
- Back examination of patients with amyloidosis is usually normal.
Genitourinary
- Genitourinary examination of patients with amyloidosis is usually normal.
Neuromuscular
- Numbness
- Paresthesia
- Pain
Extremities
- Edema
- Carpal tunnel syndrome
- Numbness of the fingers and toes
- Raynaud phenomenon
Macular Amyloidosis
-
Macular Amyloidosis
Adapted from Dermatology Atlas -
Macular Amyloidosis
Adapted from Dermatology Atlas -
Macular Amyloidosis
Adapted from Dermatology Atlas -
Macular Amyloidosis
Adapted from Dermatology Atlas -
Macular Amyloidosis
Adapted from Dermatology Atlas
Nodular Amyloidosis
-
Nodular Amyloidosis
Adapted from Dermatology Atlas -
Nodular Amyloidosis
Adapted from Dermatology Atlas -
Nodular Amyloidosis
Adapted from Dermatology Atlas -
Nodular Amyloidosis
Adapted from Dermatology Atlas
References
- ↑ Wechalekar AD, Gillmore JD, Hawkins PN (June 2016). "Systemic amyloidosis". Lancet. 387 (10038): 2641–2654. doi:10.1016/S0140-6736(15)01274-X. PMID 26719234.
- ↑ Pribitkin E, Friedman O, O'Hara B, Cunnane MF, Levi D, Rosen M, Keane WM, Sataloff RT (December 2003). "Amyloidosis of the upper aerodigestive tract". Laryngoscope. 113 (12): 2095–101. doi:10.1097/00005537-200312000-00007. PMID 14660909.
- ↑ Shin SC, Robinson-Papp J (2012). "Amyloid neuropathies". Mt. Sinai J. Med. 79 (6): 733–48. doi:10.1002/msj.21352. PMC 3531896. PMID 23239211.