Osteoporosis physical examination: Difference between revisions
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[[Osteoporosis]] is generally [[asymptomatic]] during initial years; until the [[bone mass]] loss rich to the point that [[fractures]] occur. These [[fractures]] could be divided to acute and chronic ones; mostly involve [[femoral neck]] and [[Vertebral|vertebral bones]], respectively. The main feature of [[femoral]] [[fracture]] is immobilization and the main feature of [[vertebral]] [[fracture]] is Dowager's hump appearance. | [[Osteoporosis]] is generally [[asymptomatic]] during initial years; until the [[bone mass]] loss rich to the point that [[fractures]] occur. These [[fractures]] could be divided to acute and chronic ones; mostly involve [[femoral neck]] and [[Vertebral|vertebral bones]], respectively. The main feature of [[femoral]] [[fracture]] is immobilization and the main feature of [[vertebral]] [[fracture]] is Dowager's hump appearance. | ||
=== Appearance === | === Appearance of the patient === | ||
* In case of acute [[fractures]], patients may appear [[anxious]] and distressed because of pain. Based on risk factors, the patient may likely be elderly, female, thin, of short stature, and Asian or Caucasian. | * In case of acute [[fractures]], patients may appear [[anxious]] and distressed because of pain. Based on risk factors, the patient may likely be elderly, female, thin, of short stature, and Asian or Caucasian. | ||
* If they have [[osteoporosis]] due to chronic [[steroid|corticosteroid]] use, they may also exhibit the physical characteristics of chronic [[corticosteroid]] use; such as [[Buffalo hump]], [[Striae|abdominal striae]], moon-like faces, and edematous [[eyelids]]. | * If they have [[osteoporosis]] due to chronic [[steroid|corticosteroid]] use, they may also exhibit the physical characteristics of chronic [[corticosteroid]] use; such as [[Buffalo hump]], [[Striae|abdominal striae]], moon-like faces, and edematous [[eyelids]]. | ||
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*[[Striae]] may be present, if there is chronic [[corticosteroid]] use; signifying a risk factor for [[osteoporosis]] | *[[Striae]] may be present, if there is chronic [[corticosteroid]] use; signifying a risk factor for [[osteoporosis]] | ||
=== | ===HEENT=== | ||
* Normal | * Normal | ||
* Characteristic moon-like face (i.e., round "puffy" face) may be present with chronic [[corticosteroid]] use; signifying a risk factor for [[osteoporosis]] | * Characteristic moon-like face (i.e., round "puffy" face) may be present with chronic [[corticosteroid]] use; signifying a risk factor for [[osteoporosis]] | ||
Revision as of 22:22, 14 August 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Eiman Ghaffarpasand, M.D. [2]
Overview
Osteoporosis is generally asymptomatic during initial years; until the bone mass loss rich to the point that fractures occur. These fractures could be divided to acute and chronic ones; mostly involve femoral neck and vertebral bones, respectively. The main feature of femoral fracture is immobilization and the main feature of vertebral fracture is Dowager's hump appearance. Any other secondary causes of the disease (e.g., chronic corticosteroid use or hyperthyroidism) may have their own symptoms; signifying a risk factor for osteoporosis.
Physical examination
Osteoporosis is generally asymptomatic during initial years; until the bone mass loss rich to the point that fractures occur. These fractures could be divided to acute and chronic ones; mostly involve femoral neck and vertebral bones, respectively. The main feature of femoral fracture is immobilization and the main feature of vertebral fracture is Dowager's hump appearance.
Appearance of the patient
- In case of acute fractures, patients may appear anxious and distressed because of pain. Based on risk factors, the patient may likely be elderly, female, thin, of short stature, and Asian or Caucasian.
- If they have osteoporosis due to chronic corticosteroid use, they may also exhibit the physical characteristics of chronic corticosteroid use; such as Buffalo hump, abdominal striae, moon-like faces, and edematous eyelids.
- They may exhibit physical characteristics of other secondary causes of osteoporosis, such as hyperthyroidism (include proptosis, tremor, and restlessness).
Vital Signs
Temperature
- Normal without fever
Blood pressure
- Normal
Pulse rate
- Normal rate, rhythm, and strength
Respiratory rate
- Normal
Skin
- Normal
- Striae may be present, if there is chronic corticosteroid use; signifying a risk factor for osteoporosis
HEENT
- Normal
- Characteristic moon-like face (i.e., round "puffy" face) may be present with chronic corticosteroid use; signifying a risk factor for osteoporosis
Neck
- Thyromegaly may be present in hyperthyroidism
Abdomen
- Hepatomegaly usually absent
- Hepatomegaly may be found due to hemochromatosis or alcoholism; both signifying risk factors for osteoporosis
- Central obesity and striae may be seen in chronic corticosteroid use; signifying a risk factor for osteoporosis
Back
- Point tenderness may be seen in case of fractures
- Stooped back, "Dowager's hump"; caused by compression of vertebrae
- Kyphoscoliosis may be seen
- Shortened spinal column; caused by compression of vertebrae
- Buffalo hump (Large fat pad at the back of neck) may be present due to chronic corticosteroid use; signifying a risk factor for osteoporosis
Genitourinary
- Hypogonadism may be evident; signifying a risk factor for osteoporosis
Extremities
- Fracture or previously healed fractures may be present
- Peripheral muscle atrophy may be present with chronic corticosteroid use; signifying a risk factor for osteoporosis