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===Appearance of the Patient===
===Appearance of the Patient===
*Patients with Sjögren's syndrome usually . <ref name="pmid16453296">{{cite journal |vauthors=Lopate G, Pestronk A, Al-Lozi M, Lynch T, Florence J, Miller T, Levine T, Rampy T, Beson B, Ramneantu I |title=Peripheral neuropathy in an outpatient cohort of patients with Sjögren's syndrome |journal=Muscle Nerve |volume=33 |issue=5 |pages=672–6 |date=May 2006 |pmid=16453296 |doi=10.1002/mus.20514 |url=}}</ref><ref name="pmid19254127">{{cite journal |vauthors=Antoniazzi RP, Miranda LA, Zanatta FB, Islabão AG, Gustafsson A, Chiapinotto GA, Oppermann RV |title=Periodontal conditions of individuals with Sjögren's syndrome |journal=J. Periodontol. |volume=80 |issue=3 |pages=429–35 |date=March 2009 |pmid=19254127 |doi=10.1902/jop.2009.080350 |url=}}</ref><ref name="pmid19307256">{{cite journal |vauthors=Riccieri V, Sciarra I, Ceccarelli F, Alessandri C, Croia C, Vasile M, Modesti MG, Priori R, Valesini G |title=Nailfold capillaroscopy abnormalities are associated with the presence of anti-endothelial cell antibodies in Sjogren's syndrome |journal=Rheumatology (Oxford) |volume=48 |issue=6 |pages=704–6 |date=June 2009 |pmid=19307256 |doi=10.1093/rheumatology/kep051 |url=}}</ref><ref name="pmid18085734">{{cite journal |vauthors=Ren H, Wang WM, Chen XN, Zhang W, Pan XX, Wang XL, Lin Y, Zhang S, Chen N |title=Renal involvement and followup of 130 patients with primary Sjögren's syndrome |journal=J. Rheumatol. |volume=35 |issue=2 |pages=278–84 |date=February 2008 |pmid=18085734 |doi= |url=}}</ref><ref name="pmid16397619">{{cite journal |vauthors=Versura P, Frigato M, Cellini M, Mulè R, Malavolta N, Campos EC |title=Diagnostic performance of tear function tests in Sjogren's syndrome patients |journal=Eye (Lond) |volume=21 |issue=2 |pages=229–37 |date=February 2007 |pmid=16397619 |doi=10.1038/sj.eye.6702204 |url=}}</ref><ref name="pmid18599017">{{cite journal |vauthors=Lemp MA |title=Advances in understanding and managing dry eye disease |journal=Am. J. Ophthalmol. |volume=146 |issue=3 |pages=350–356 |date=September 2008 |pmid=18599017 |doi=10.1016/j.ajo.2008.05.016 |url=}}</ref>
*Patients with Sjögren's syndrome usually ocular and oral dryness. <ref name="pmid16453296">{{cite journal |vauthors=Lopate G, Pestronk A, Al-Lozi M, Lynch T, Florence J, Miller T, Levine T, Rampy T, Beson B, Ramneantu I |title=Peripheral neuropathy in an outpatient cohort of patients with Sjögren's syndrome |journal=Muscle Nerve |volume=33 |issue=5 |pages=672–6 |date=May 2006 |pmid=16453296 |doi=10.1002/mus.20514 |url=}}</ref><ref name="pmid19254127">{{cite journal |vauthors=Antoniazzi RP, Miranda LA, Zanatta FB, Islabão AG, Gustafsson A, Chiapinotto GA, Oppermann RV |title=Periodontal conditions of individuals with Sjögren's syndrome |journal=J. Periodontol. |volume=80 |issue=3 |pages=429–35 |date=March 2009 |pmid=19254127 |doi=10.1902/jop.2009.080350 |url=}}</ref><ref name="pmid19307256">{{cite journal |vauthors=Riccieri V, Sciarra I, Ceccarelli F, Alessandri C, Croia C, Vasile M, Modesti MG, Priori R, Valesini G |title=Nailfold capillaroscopy abnormalities are associated with the presence of anti-endothelial cell antibodies in Sjogren's syndrome |journal=Rheumatology (Oxford) |volume=48 |issue=6 |pages=704–6 |date=June 2009 |pmid=19307256 |doi=10.1093/rheumatology/kep051 |url=}}</ref><ref name="pmid18085734">{{cite journal |vauthors=Ren H, Wang WM, Chen XN, Zhang W, Pan XX, Wang XL, Lin Y, Zhang S, Chen N |title=Renal involvement and followup of 130 patients with primary Sjögren's syndrome |journal=J. Rheumatol. |volume=35 |issue=2 |pages=278–84 |date=February 2008 |pmid=18085734 |doi= |url=}}</ref><ref name="pmid16397619">{{cite journal |vauthors=Versura P, Frigato M, Cellini M, Mulè R, Malavolta N, Campos EC |title=Diagnostic performance of tear function tests in Sjogren's syndrome patients |journal=Eye (Lond) |volume=21 |issue=2 |pages=229–37 |date=February 2007 |pmid=16397619 |doi=10.1038/sj.eye.6702204 |url=}}</ref><ref name="pmid18599017">{{cite journal |vauthors=Lemp MA |title=Advances in understanding and managing dry eye disease |journal=Am. J. Ophthalmol. |volume=146 |issue=3 |pages=350–356 |date=September 2008 |pmid=18599017 |doi=10.1016/j.ajo.2008.05.016 |url=}}</ref>


===Vital Signs===
===Vital Signs===

Revision as of 19:00, 2 April 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Farima Kahe M.D. [2]

Overview

Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].

OR

Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

The presence of [finding(s)] on physical examination is diagnostic of [disease name].

OR

The presence of [finding(s)] on physical examination is highly suggestive of [disease name].

Physical Examination

  • Physical examination of patients with [disease name] is usually normal.

OR

  • Physical examination of patients with [disease name] is usually remarkable for:[finding 1], [finding 2], and [finding 3].
  • The presence of [finding(s)] on physical examination is diagnostic of [disease name].
  • The presence of [finding(s)] on physical examination is highly suggestive of [disease name].

Appearance of the Patient

Vital Signs

  • Vital sign might be normal.

Skin

  • Dryness of the skin
  • Scaling
  • Partial or complete loss of sweating
  • Dry, sparse, and brittle hair may be present
  • Diffuse alopecia may involve the scalp, limbs, axillae, or pubis
  • Nail folds may show capillaroscopic abnormalities
  • Nonpalpable or palpable, vasculitic purpura, with lesions that are typically 2-3 mm in diameter and located on the lower extremities may be present
  • Annular erythema with scales, localized especially on the face and neck

HEENT

  • Mucous dryness
  • Red, smooth, and dry tongue
  • Dental caries
  • Gingival inflammation
  • Parotid duct narrowing
  • Red, dry, and scaly lips
  • Cracks at the corners of the mouth
  • Chronic oral candidiasis
  • Atrophic changes in the mucous membranes of the upper respiratory tract

Neck

  • Bilateral parotid gland enlargement

Lungs

  • Bibasilar rales nt
  • Wheezing may be present

Heart

  • Cardiovascular examination of patients with Sjögren's syndrome is usually normal.

Abdomen

  • Splenomegaly

Back

  • Back examination of patients with Sjögren's syndrome is usually normal.

Genitourinary

  • Irritated bladder
  • Suprapubic pain
  • Atrophic changes in the vulva and vagin
  • Dryness of the anal and rectal mucous membranes

Neuromuscular

  • Patient is usually oriented to persons, place, and time.
  • Glasgow coma scale is 15/15
  • Paraparesis maybe present
  • Paraplegia may be present

Extremities

  • Symmetrical, polyarticular, inflammatory arthritis

References

  1. ↑ Lopate G, Pestronk A, Al-Lozi M, Lynch T, Florence J, Miller T, Levine T, Rampy T, Beson B, Ramneantu I (May 2006). "Peripheral neuropathy in an outpatient cohort of patients with Sjögren's syndrome". Muscle Nerve. 33 (5): 672–6. doi:10.1002/mus.20514. PMID 16453296.
  2. ↑ Antoniazzi RP, Miranda LA, Zanatta FB, Islabão AG, Gustafsson A, Chiapinotto GA, Oppermann RV (March 2009). "Periodontal conditions of individuals with Sjögren's syndrome". J. Periodontol. 80 (3): 429–35. doi:10.1902/jop.2009.080350. PMID 19254127.
  3. ↑ Riccieri V, Sciarra I, Ceccarelli F, Alessandri C, Croia C, Vasile M, Modesti MG, Priori R, Valesini G (June 2009). "Nailfold capillaroscopy abnormalities are associated with the presence of anti-endothelial cell antibodies in Sjogren's syndrome". Rheumatology (Oxford). 48 (6): 704–6. doi:10.1093/rheumatology/kep051. PMID 19307256.
  4. ↑ Ren H, Wang WM, Chen XN, Zhang W, Pan XX, Wang XL, Lin Y, Zhang S, Chen N (February 2008). "Renal involvement and followup of 130 patients with primary Sjögren's syndrome". J. Rheumatol. 35 (2): 278–84. PMID 18085734.
  5. ↑ Versura P, Frigato M, Cellini M, Mulè R, Malavolta N, Campos EC (February 2007). "Diagnostic performance of tear function tests in Sjogren's syndrome patients". Eye (Lond). 21 (2): 229–37. doi:10.1038/sj.eye.6702204. PMID 16397619.
  6. ↑ Lemp MA (September 2008). "Advances in understanding and managing dry eye disease". Am. J. Ophthalmol. 146 (3): 350–356. doi:10.1016/j.ajo.2008.05.016. PMID 18599017.

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