Cystitis physical examination: Difference between revisions
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===Vital Signs=== | ===Vital Signs=== | ||
*[[Fever]] rarely present<ref name="pmid16716786">{{cite journal| author=Chang SL, Shortliffe LD| title=Pediatric urinary tract infections. | journal=Pediatr Clin North Am | year= 2006 | volume= 53 | issue= 3 | pages= 379-400, vi | pmid=16716786 | doi=10.1016/j.pcl.2006.02.011 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16716786 }} </ref><ref name="pmid18055650">{{cite journal| author=Azzarone G, Liewehr S, O'Connor K| title=Cystitis. | journal=Pediatr Rev | year= 2007 | volume= 28 | issue= 12 | pages= 474-6 | pmid=18055650 | doi=10.1542/pir.28-12-474 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18055650 }} </ref> | *[[Fever]] rarely present<ref name="pmid16716786">{{cite journal| author=Chang SL, Shortliffe LD| title=Pediatric urinary tract infections. | journal=Pediatr Clin North Am | year= 2006 | volume= 53 | issue= 3 | pages= 379-400, vi | pmid=16716786 | doi=10.1016/j.pcl.2006.02.011 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16716786 }} </ref><ref name="pmid18055650">{{cite journal| author=Azzarone G, Liewehr S, O'Connor K| title=Cystitis. | journal=Pediatr Rev | year= 2007 | volume= 28 | issue= 12 | pages= 474-6 | pmid=18055650 | doi=10.1542/pir.28-12-474 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18055650 }} </ref> | ||
=== Skin === | |||
* Skin examination of patients with pyelonephritis is usually normal. | |||
=== HEENT === | |||
* HEENT examination of patients with pyelonephritis is usually normal. | |||
=== Neck === | |||
* Neck examination of patients with pyelonephritis is usually normal. | |||
=== Lungs === | |||
* Pulmonary examination of patients with pyelonephritis is usually normal. | |||
=== Heart === | |||
* [[Tachycardia]] | |||
===Abdomen=== | |||
* [[Costovertebral angle]] tenderness | |||
* Positive sonopalpation test of the kidney<ref name="pmid28050884">{{cite journal| author=Faust JS, Tsung JW| title=Eliciting renal tenderness by sonopalpation in diagnosing acute pyelonephritis. | journal=Crit Ultrasound J | year= 2017 | volume= 9 | issue= 1 | pages= 1 | pmid=28050884 | doi=10.1186/s13089-016-0056-6 | pmc=5215196 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28050884 }} </ref> | |||
* Suprapubic [[tenderness]] | |||
===Digital rectal examination (DRE)=== | |||
A [[digital rectal exam]] is a procedure performed in an office setting. The patient bends on a table or lays on one side with knees touching chest. The physician wears gloves, applies a lubricant to the gloved finger and enters it into the rectum to feel the prostate normally located in front of the rectum. | |||
*If pyelonephritis is suspected in men, a [[Digital rectal examination|DRE]] helps to differentiate if the obstruction is due to a swollen [[prostate gland]]. | |||
=== Back === | |||
* [[Costovertebral angle]] tenderness | |||
===Genitourinary=== | |||
The following findings may be found on genitourinary examination of a patient with pyelonephritis:<ref name="pmid22010614">{{cite journal| author=Colgan R, Williams M| title=Diagnosis and treatment of acute uncomplicated cystitis. | journal=Am Fam Physician | year= 2011 | volume= 84 | issue= 7 | pages= 771-6 | pmid=22010614 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22010614 }} </ref><ref name="pmid20353145">{{cite journal |vauthors=Brill JR |title=Diagnosis and treatment of urethritis in men |journal=Am Fam Physician |volume=81 |issue=7 |pages=873–8 |year=2010 |pmid=20353145 |doi= |url=}}</ref><ref>{{cite book |last = Bennett |first = John |title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases |publisher = Elsevier/Saunders |location = Philadelphia, PA |year = 2015 |isbn=9781455748013}}</ref> | |||
*[[Tenderness|Suprapubic tenderness]] | |||
*[[Urethral discharge]] (if the cause is urethritis) | |||
*[[Lymphadenopathy|Inguinal lymphadenopathy]] | |||
*Examination of the scrotum and the pubic area must be done | |||
===Neuromuscular=== | |||
* Patient is usually oriented to persons, place, and time. | |||
* The following neurological signs can rarely be witnessed in elderly: | |||
**[[Delirium]] | |||
**[[Hallucinations]] | |||
=== Extremities === | |||
* Extremities examination of patients with pyelonephritis is usually normal. | |||
===Genitourinary=== | ===Genitourinary=== |
Revision as of 14:19, 14 June 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maliha Shakil, M.D. [2], Usama Talib, BSc, MD [3]
Overview
Patients with cystitis are usually well-appearing. Common physical examination findings of cystitis include fever and suprapubic tenderness. A focused physical examination is helpful in confirming the suspicion of cystitis and in ruling out alternate pathology.
Physical Examination
The following features can be found during a physical examination of a patient with cystitis. The patient must be in supine position to facilitate a proper examination.[1]
General Appearance of the Patient
- Patients with cystitis are usually normal in appearance and not in distress.[2]
Vital Signs
Skin
- Skin examination of patients with pyelonephritis is usually normal.
HEENT
- HEENT examination of patients with pyelonephritis is usually normal.
Neck
- Neck examination of patients with pyelonephritis is usually normal.
Lungs
- Pulmonary examination of patients with pyelonephritis is usually normal.
Heart
Abdomen
- Costovertebral angle tenderness
- Positive sonopalpation test of the kidney[5]
- Suprapubic tenderness
Digital rectal examination (DRE)
A digital rectal exam is a procedure performed in an office setting. The patient bends on a table or lays on one side with knees touching chest. The physician wears gloves, applies a lubricant to the gloved finger and enters it into the rectum to feel the prostate normally located in front of the rectum.
- If pyelonephritis is suspected in men, a DRE helps to differentiate if the obstruction is due to a swollen prostate gland.
Back
- Costovertebral angle tenderness
Genitourinary
The following findings may be found on genitourinary examination of a patient with pyelonephritis:[2][6][7]
- Suprapubic tenderness
- Urethral discharge (if the cause is urethritis)
- Inguinal lymphadenopathy
- Examination of the scrotum and the pubic area must be done
Neuromuscular
- Patient is usually oriented to persons, place, and time.
- The following neurological signs can rarely be witnessed in elderly:
Extremities
- Extremities examination of patients with pyelonephritis is usually normal.
Genitourinary
The following findings may be found on genitourinary examination of a patient with cystitis.[2][6][8].
- Suprapubic tenderness
- Urethral discharge(if the cause is urethritis)
- Inguinal lymphadenopathy
- Examination of the scrotum and the pubic area must be done
Abdominal
The following findings can be found on abdominal examination of cystitis.[2]
- Abdominal tenderness on palpation
Cardiovascular
Neurological
References
- ↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 9781455748013.
- ↑ 2.0 2.1 2.2 2.3 Colgan R, Williams M (2011). "Diagnosis and treatment of acute uncomplicated cystitis". Am Fam Physician. 84 (7): 771–6. PMID 22010614.
- ↑ Chang SL, Shortliffe LD (2006). "Pediatric urinary tract infections". Pediatr Clin North Am. 53 (3): 379–400, vi. doi:10.1016/j.pcl.2006.02.011. PMID 16716786.
- ↑ Azzarone G, Liewehr S, O'Connor K (2007). "Cystitis". Pediatr Rev. 28 (12): 474–6. doi:10.1542/pir.28-12-474. PMID 18055650.
- ↑ Faust JS, Tsung JW (2017). "Eliciting renal tenderness by sonopalpation in diagnosing acute pyelonephritis". Crit Ultrasound J. 9 (1): 1. doi:10.1186/s13089-016-0056-6. PMC 5215196. PMID 28050884.
- ↑ 6.0 6.1 Brill JR (2010). "Diagnosis and treatment of urethritis in men". Am Fam Physician. 81 (7): 873–8. PMID 20353145.
- ↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 9781455748013.
- ↑ Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 9781455748013.