Cushing's syndrome physical examination: Difference between revisions
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{{Cushing's syndrome}} | {{Cushing's syndrome}} | ||
{{CMG}} {{AE}} {{MMF}} | |||
{{CMG}} | |||
==Overview== | ==Overview== | ||
Patients with [[Cushing's syndrome]] usually appear obese. Physical examination of patients with Cushing's syndrome is remarkable for moon-like facies, [[easy bruising]], purple skin striae, and [[hirsutism]]. | |||
==Physical Examination== | ==Physical Examination== | ||
=== | Physical examination of patients with Cushing's syndrome is as follows:<ref name="pmid26156970">{{cite journal |vauthors=Nieman LK |title=Cushing's syndrome: update on signs, symptoms and biochemical screening |journal=Eur. J. Endocrinol. |volume=173 |issue=4 |pages=M33–8 |year=2015 |pmid=26156970 |pmc=4553096 |doi=10.1530/EJE-15-0464 |url=}}</ref> | ||
* | ===Appearance of the patient=== | ||
*Patients with Cushing's syndrome are usually [[overweight]]. | |||
===Vital signs=== | |||
[[ | * [[Hypertension]], due to [[Cortisol|cortisol's]] enhancement of [[epinephrine]]'s [[vasoconstrictive]] effect. | ||
===Head=== | ===Head=== | ||
*[[Moon face|Moon-face]] is a medical sign where the face swells up into a rounded shape. It is often associated with [[Cushing's syndrome]], which has led to it being known as Cushingoid facies ("Cushings-like face"), or [[steroid]] treatment, which has led to the name steroid facies. | |||
===Skin=== | ===Skin=== | ||
* [[Hyperpigmentation]] - this is due to | * [[Hyperpigmentation]] - this is due to [[melanocyte stimulating hormone]] ([[MSH]]) production, as a byproduct of [[Adrenocorticotropic hormone|ACTH]] synthesis from [[Proopiomelanocortin|Proopiomelanocortin (POMC)]] | ||
* [[Telangiectasia]] (dilation of capillaries) | * [[Telangiectasia]] (dilation of [[capillaries]]) | ||
* Thinning of the skin (which causes easy bruising) | * Thinning of the skin (which causes [[easy bruising]]) | ||
* Purple or red [[striae]] (the weight gain in Cushing's stretches the skin, which is thin and weakened, causing it to hemorrhage) on the trunk, buttocks, arms, legs or breasts, proximal muscle weakness (hips, shoulders) | * Purple or red [[striae]] (the weight gain in Cushing's stretches the skin, which is thin and weakened, causing it to [[hemorrhage]]) on the trunk, buttocks, arms, legs or breasts, proximal muscle weakness (hips, shoulders) | ||
* [[Hirsutism]] (facial male-pattern hair growth) | * [[Hirsutism]] (facial male-pattern hair growth) | ||
===Eye=== | ===Eye=== | ||
* [[Bitemporal hemianopsia]] - pituitary lesion may | * [[Bitemporal hemianopsia]] - pituitary lesion may cause compression of the [[optic chiasm]]. | ||
===Neck=== | ===Neck=== | ||
* Growth of fat pads along the collar bone and on the back of the neck (known as | * Growth of fat pads along the [[collar bone]] and on the back of the neck (known as [[lipodystrophy]]). | ||
[[Image:Cushings-syndrome.jpg|thumb|center|Features of Cushing's syndrome(Image courtesy of Jessica Stevenson, and http://www.physio-pedia.com/File:Cushings-syndrome2.jpg#filelinks)|325px]] | |||
==References== | ==References== | ||
[[Category:Needs content]] | [[Category:Needs content]] | ||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
<references /> | |||
Latest revision as of 19:58, 20 October 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Furqan M M. M.B.B.S[2]
Overview
Patients with Cushing's syndrome usually appear obese. Physical examination of patients with Cushing's syndrome is remarkable for moon-like facies, easy bruising, purple skin striae, and hirsutism.
Physical Examination
Physical examination of patients with Cushing's syndrome is as follows:[1]
Appearance of the patient
- Patients with Cushing's syndrome are usually overweight.
Vital signs
- Hypertension, due to cortisol's enhancement of epinephrine's vasoconstrictive effect.
Head
- Moon-face is a medical sign where the face swells up into a rounded shape. It is often associated with Cushing's syndrome, which has led to it being known as Cushingoid facies ("Cushings-like face"), or steroid treatment, which has led to the name steroid facies.
Skin
- Hyperpigmentation - this is due to melanocyte stimulating hormone (MSH) production, as a byproduct of ACTH synthesis from Proopiomelanocortin (POMC)
- Telangiectasia (dilation of capillaries)
- Thinning of the skin (which causes easy bruising)
- Purple or red striae (the weight gain in Cushing's stretches the skin, which is thin and weakened, causing it to hemorrhage) on the trunk, buttocks, arms, legs or breasts, proximal muscle weakness (hips, shoulders)
- Hirsutism (facial male-pattern hair growth)
Eye
- Bitemporal hemianopsia - pituitary lesion may cause compression of the optic chiasm.
Neck
- Growth of fat pads along the collar bone and on the back of the neck (known as lipodystrophy).
References
- ↑ Nieman LK (2015). "Cushing's syndrome: update on signs, symptoms and biochemical screening". Eur. J. Endocrinol. 173 (4): M33–8. doi:10.1530/EJE-15-0464. PMC 4553096. PMID 26156970.