Vasculitis physical examination: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Vasculitis}} | {{Vasculitis}} | ||
{{CMG}}; {{AE}} {{MUT}} {{JH}} {{KS}} | |||
{{CMG}}; | |||
==Overview== | ==Overview== | ||
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| [[Image:Skin_vasculitis7.jpg|thumb|Vasculitis: In this instance, idiopathic.]] | | [[Image:Skin_vasculitis7.jpg|thumb|Vasculitis: In this instance, idiopathic.]] | ||
| [[Image:skin_vasculitis5.jpg|thumb|Vasculitis: In this instance, idiopathic with palpable purpura.]] | | [[Image:skin_vasculitis5.jpg|thumb|Vasculitis: In this instance, idiopathic with palpable purpura.]] | ||
|} | |} | ||
<br clear="left"/> | <br clear="left"/> | ||
'''Images of [[vasculitis]] after Streptococcal throat infection''' | |||
[[File:Strep vasculitis 1.jpg|Streptococcal vasculitis|left|300px]] | |||
[[File:Strep vasculitis 2.jpg|Streptococcal vasculitis|left|300px]] | |||
<br style="clear:left" /> | |||
===Eye=== | ===Eye=== | ||
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===Gallery=== | ===Gallery=== | ||
====Lower extremity==== | |||
<gallery> | <gallery> | ||
Image:Allergic vasculitis_01.jpeg|Allergic vasculitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId= | Image:Allergic vasculitis_01.jpeg|Allergic vasculitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=22 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=22> | ||
Image:Allergic vasculitis_02.jpeg|Allergic vasculitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=22 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=22> | |||
Image:Allergic vasculitis_03.jpeg|Allergic vasculitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=22 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=22> | |||
Image:Allergic vasculitis_04.jpeg|Allergic vasculitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=22 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=22> | |||
Image:Allergic vasculitis_05.jpeg|Allergic vasculitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=22 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=22> | |||
Image:Allergic | Image:Allergic vasculitis_06.jpeg|Allergic vasculitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=22 With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf? | ||
diseaseId=22> | |||
Image: | Image:Allergicvasculitis07.jpg|.Allergicvasculitis <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL> | ||
Image:Allergicvasculitis08.jpg|.Allergicvasculitis <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL> | |||
Image:Allergicvasculitis09.jpg|.Allergicvasculitis <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL> | |||
Image:Allergicvasculitis10.jpg|.Allergicvasculitis <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL> | |||
Image:Allergicvasculitis11.jpg|.Allergicvasculitis <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL> | |||
Image:Allergicvasculitis12.jpg|.Allergicvasculitis <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL> | |||
Image:Allergicvasculitis13.jpg|.Allergicvasculitis <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL> | |||
Image:Allergicvasculitis14.jpg|.Allergicvasculitis <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/ Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL> | |||
</gallery> | </gallery> | ||
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==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Rheumatology]] | |||
{{WH}} | {{WH}} | ||
{{WS}} | {{WS}} | ||
Latest revision as of 17:47, 19 June 2017
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Vasculitis |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: M.Umer Tariq [2] Jesus Rosario Hernandez, M.D. [3] Kiran Singh, M.D. [4]
Overview
Physical Examination
Vitals
Temperature
- Elevated body temperature may be present (fever)
Pulse
Rate
- Tachycardia may be present
Strength
- Decreased pulsation of one or both brachial arteries - Takayasu arteritis
- Decreased pulsations in the temporal artery - Temporal arteritis
Blood Pressure
- At least 10 mmHg systolic difference in both arms - in Takayasu arteritis
- New onset diastolic blood pressure > 90 mmHg - Polyarteritis nodosa
Skin
- Palpable purpura - if patients have this in isolation, it is most likely due to cutaneous leukocytoclastic vasculitis. If the purpura is in combination with systemic organ involvement, it is most likely to be Henoch-Schonlein purpura or microscopic polyarteritis.
- Livedo reticularis - Polyarteritis nodosa
- Erythema of palms/soles, edema of hands/feet, periungual desquamation, polymorphous rash - Kawasaki disease
- Palpable purpura, maculopapular rash - Hypersensitivity vasculitis
(Images courtesy of Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, CA)
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Images of vasculitis after Streptococcal throat infection
Eye
- Bilateral conjunctival injection - Kawasaki disease
Head
- Tenderness on the sides of the head - Temporal arteritis
- Tenderness on the head may be present in Takayasu arteritis
- Nasal or oral inflammation (oral ulcers or purulent/bloody nasal discharge, may be painful) - Wegener's granulomatosis
- Cervical lymphadenopathy (at least one node > 1.5 cm), injected or fissured lips, injected pharynx, or strawberry tongue - Kawasaki disease
Heart
Auscultation
- Bruit over one or both carotid arteries or abdominal aorta - Takayasu arteritis
Extremities
- Claudication
Gallery
Lower extremity
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![.Allergicvasculitis Adapted from Dermatology Atlas.[1]](/images/b/b1/Allergicvasculitis07.jpg)
.Allergicvasculitis Adapted from Dermatology Atlas.[1]
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![.Allergicvasculitis Adapted from Dermatology Atlas.[1]](/images/4/41/Allergicvasculitis08.jpg)
.Allergicvasculitis Adapted from Dermatology Atlas.[1]
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![.Allergicvasculitis Adapted from Dermatology Atlas.[1]](/images/8/83/Allergicvasculitis09.jpg)
.Allergicvasculitis Adapted from Dermatology Atlas.[1]
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![.Allergicvasculitis Adapted from Dermatology Atlas.[1]](/images/a/a8/Allergicvasculitis10.jpg)
.Allergicvasculitis Adapted from Dermatology Atlas.[1]
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![.Allergicvasculitis Adapted from Dermatology Atlas.[1]](/images/5/54/Allergicvasculitis11.jpg)
.Allergicvasculitis Adapted from Dermatology Atlas.[1]
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![.Allergicvasculitis Adapted from Dermatology Atlas.[1]](/images/2/22/Allergicvasculitis12.jpg)
.Allergicvasculitis Adapted from Dermatology Atlas.[1]
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![.Allergicvasculitis Adapted from Dermatology Atlas.[1]](/images/e/e8/Allergicvasculitis13.jpg)
.Allergicvasculitis Adapted from Dermatology Atlas.[1]
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![.Allergicvasculitis Adapted from Dermatology Atlas.[1]](/images/e/e3/Allergicvasculitis14.jpg)
.Allergicvasculitis Adapted from Dermatology Atlas.[1]
![.Allergicvasculitis Adapted from Dermatology Atlas.[1]](/index.php/File:Allergicvasculitis07.jpg)
![.Allergicvasculitis Adapted from Dermatology Atlas.[1]](/index.php/File:Allergicvasculitis08.jpg)
![.Allergicvasculitis Adapted from Dermatology Atlas.[1]](/index.php/File:Allergicvasculitis09.jpg)
![.Allergicvasculitis Adapted from Dermatology Atlas.[1]](/index.php/File:Allergicvasculitis10.jpg)
![.Allergicvasculitis Adapted from Dermatology Atlas.[1]](/index.php/File:Allergicvasculitis11.jpg)
![.Allergicvasculitis Adapted from Dermatology Atlas.[1]](/index.php/File:Allergicvasculitis12.jpg)
![.Allergicvasculitis Adapted from Dermatology Atlas.[1]](/index.php/File:Allergicvasculitis13.jpg)
![.Allergicvasculitis Adapted from Dermatology Atlas.[1]](/index.php/File:Allergicvasculitis14.jpg)
Neurologic