Mixed connective tissue disease physical examination: Difference between revisions
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* Patient appears ill in the late stages of the disease due to multi-organ involvement | * Patient appears ill in the late stages of the disease due to multi-organ involvement | ||
===Vital Signs=== | ===Vital Signs<ref name="pmid15716315">{{cite journal |vauthors=Bodolay E, Szekanecz Z, Dévényi K, Galuska L, Csípo I, Vègh J, Garai I, Szegedi G |title=Evaluation of interstitial lung disease in mixed connective tissue disease (MCTD) |journal=Rheumatology (Oxford) |volume=44 |issue=5 |pages=656–61 |date=May 2005 |pmid=15716315 |doi=10.1093/rheumatology/keh575 |url=}}</ref>=== | ||
*[[Tachycardia]] | *[[Tachycardia]] | ||
*[[Tachypnea]] | *[[Tachypnea]] | ||
===Skin=== | ===Skin<ref name="pmid23756459">{{cite journal |vauthors=Dabiri G, Falanga V |title=Connective tissue ulcers |journal=J Tissue Viability |volume=22 |issue=4 |pages=92–102 |date=November 2013 |pmid=23756459 |pmc=3930159 |doi=10.1016/j.jtv.2013.04.003 |url=}}</ref>=== | ||
* Edema of the hands | |||
* Calcinosis | |||
* Telangiectasia | |||
* Malar rash | |||
* Periungual [[Telangiectasia|telangiectasias]] and [[erythema]] may be present | * Periungual [[Telangiectasia|telangiectasias]] and [[erythema]] may be present | ||
* Skin may be [[pale]] (secondary to [[anemia]]) | * Skin may be [[pale]] (secondary to [[anemia]]) | ||
| Line 27: | Line 31: | ||
===HEENT=== | ===HEENT=== | ||
* HEENT examination of patients with mixed connective tissue disease is usually normal. | * HEENT examination of patients with mixed connective tissue disease is usually normal. | ||
===Neck | ===Neck<ref name="pmid24353496">{{cite journal |vauthors=Latuśkiewicz-Potemska J, Zygmunt A, Biernacka-Zielińska M, Stańczyk J, Smolewska E |title=Mixed connective tissue disease presenting with progressive scleroderma symptoms in a 10-year-old girl |journal=Postepy Dermatol Alergol |volume=30 |issue=5 |pages=329–36 |date=October 2013 |pmid=24353496 |pmc=3858664 |doi=10.5114/pdia.2013.38365 |url=}}</ref>=== | ||
* [[Lymphadenopathy]] | |||
* [[Jugular venous distension]] (suggests [[pulmonary hypertension]]) | * [[Jugular venous distension]] (suggests [[pulmonary hypertension]]) | ||
===Lungs | ===Lungs<ref name="pmid157163152">{{cite journal |vauthors=Bodolay E, Szekanecz Z, Dévényi K, Galuska L, Csípo I, Vègh J, Garai I, Szegedi G |title=Evaluation of interstitial lung disease in mixed connective tissue disease (MCTD) |journal=Rheumatology (Oxford) |volume=44 |issue=5 |pages=656–61 |date=May 2005 |pmid=15716315 |doi=10.1093/rheumatology/keh575 |url=}}</ref>=== | ||
* Bibasilar [[Rales|crackles]] | |||
*[[Rhonchi]] | *[[Rhonchi]] | ||
*[[Wheezing]] may be present | *[[Wheezing]] may be present | ||
Revision as of 13:44, 4 May 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shaghayegh Habibi, M.D.[2]
Overview
Physical examination of patients with MCTD is usually remarkable by clinical features seen in systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), dermatomyositis (DM), polymyositis, and scleroderma. Physical examination in patients with MCTD include tachycardia, tachypnea, periungual telangiectasia, sclerodactyly, jugular vein distention, rhonchi and wheezing, joint swelling and tenderness, and joints erythema and effusion.
Physical Examination
- Physical examination of patients with MCTD is usually remarkable by clinical features seen in systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), dermatomyositis (DM), polymyositis, and scleroderma.
Appearance of the Patient
- Patient appears well in the earlier stages of the disease
- Patient appears ill in the late stages of the disease due to multi-organ involvement
Vital Signs[1]
Skin[2]
- Edema of the hands
- Calcinosis
- Telangiectasia
- Malar rash
- Periungual telangiectasias and erythema may be present
- Skin may be pale (secondary to anemia)
- Sclerodactyly
- Skin ulceration
HEENT
- HEENT examination of patients with mixed connective tissue disease is usually normal.
Neck[3]
Lungs[4]
Heart
- Cardiovascular examination of patients with mixed connective tissue disease is usually normal.
Abdomen
- Abdominal examination of patients with mixed connective tissue disease is usually normal.
Genitourinary
- Genitourinary examination of patients with mixed connective tissue disease is usually normal.
Extremities
- Joint swelling and tenderness (features of rheumatologic disease)
- Arthritis
- Symmetric and polyarticular
- Majority of times involve knees, carpal joints, and joints of the fingers, especially the proximal interphalangeal (PIP) joint
- Decrease range of motion
- Joints erythema (due to synovitis)
- Joint effusion
References
- ↑ Bodolay E, Szekanecz Z, Dévényi K, Galuska L, Csípo I, Vègh J, Garai I, Szegedi G (May 2005). "Evaluation of interstitial lung disease in mixed connective tissue disease (MCTD)". Rheumatology (Oxford). 44 (5): 656–61. doi:10.1093/rheumatology/keh575. PMID 15716315.
- ↑ Dabiri G, Falanga V (November 2013). "Connective tissue ulcers". J Tissue Viability. 22 (4): 92–102. doi:10.1016/j.jtv.2013.04.003. PMC 3930159. PMID 23756459.
- ↑ Latuśkiewicz-Potemska J, Zygmunt A, Biernacka-Zielińska M, Stańczyk J, Smolewska E (October 2013). "Mixed connective tissue disease presenting with progressive scleroderma symptoms in a 10-year-old girl". Postepy Dermatol Alergol. 30 (5): 329–36. doi:10.5114/pdia.2013.38365. PMC 3858664. PMID 24353496.
- ↑ Bodolay E, Szekanecz Z, Dévényi K, Galuska L, Csípo I, Vègh J, Garai I, Szegedi G (May 2005). "Evaluation of interstitial lung disease in mixed connective tissue disease (MCTD)". Rheumatology (Oxford). 44 (5): 656–61. doi:10.1093/rheumatology/keh575. PMID 15716315.