Hepatitis B physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

For the majority of patients with acute and chronic hepatitis B, the physical examination is normal.

Physical Examination

The aim of the initial physical examination is to observe for the presence of signs of chronic liver disease which include the following:

Skin

• Jaundice
• Palmar erythema
• Spider angiomata
• Gynecomastia

HEENT

• Icterus

Abdomen

• Hepatomegaly
• Shrunken liver
• Splenomegaly
• Ascites
• Caput medusae

Extremities

• Peripheral edema
• Dupuytren's contracture

Neurologic

• Asterixis
• Neurologic manifestations in cases of HBV progression to hepatic encephalopathy include a wide spectrum of cognitive impairment and motor system abnormalities,

Extrahepatic Manifestations

• Arthritis-dermatitis syndrome:
  • Urticaria
  • Petechiae
  • Palpable purpura
  • Arthralgia
  • Arthritis of small joints

• Neuropathy

References

Spider angiomata in 47-year-old patient had longstanding jaundice and ascites consequent to biopsy-proven hepatic cirrhosis.