Osteoporosis physical examination: Difference between revisions
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===Vital Signs=== | ===Vital Signs=== | ||
All [[vital signs]] (i.e., [[blood pressure]], [[pulse rate]], [[respiratory rate]], and [[temperature]]) are normal in [[osteoporosis]]. | |||
===Skin=== | ===Skin=== | ||
*Normal | *Normal | ||
*[[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]].<ref name="pmid9648484">{{cite journal |vauthors=Tomita A |title=[Glucocorticoid-induced osteoporosis--mechanisms and preventions] |language=Japanese |journal=Nippon Rinsho |volume=56 |issue=6 |pages=1574–8 |year=1998 |pmid=9648484 |doi= |url=}}</ref> | ||
===HEENT=== | ===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]].<ref name="pmid9648484" /> | ||
===Neck=== | ===Neck=== | ||
*[[Thyromegaly]] may be present in [[hyperthyroidism]] | *[[Thyromegaly]] may be present in [[hyperthyroidism]].<ref name="pmid21966645">{{cite journal| author=Dhanwal DK| title=Thyroid disorders and bone mineral metabolism. | journal=Indian J Endocrinol Metab | year= 2011 | volume= 15 | issue= Suppl 2 | pages= S107-12 | pmid=21966645 | doi=10.4103/2230-8210.83339 | pmc=3169869 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21966645 }}</ref> | ||
===Abdomen=== | ===Abdomen=== | ||
*[[Hepatomegaly]] usually absent | *[[Hepatomegaly]] usually absent | ||
**[[Hepatomegaly]] may be found due to [[hemochromatosis]] or [[alcoholism]]; both signifying risk factors for [[osteoporosis]] | **[[Hepatomegaly]] may be found due to [[hemochromatosis]] or [[alcoholism]]; both signifying risk factors for [[osteoporosis]].<ref name="pmid22361033">{{cite journal| author=Linguraru MG, Sandberg JK, Jones EC, Petrick N, Summers RM| title=Assessing hepatomegaly: automated volumetric analysis of the liver. | journal=Acad Radiol | year= 2012 | volume= 19 | issue= 5 | pages= 588-98 | pmid=22361033 | doi=10.1016/j.acra.2012.01.015 | pmc=3319283 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22361033 }}</ref> | ||
*Central [[obesity]] and [[striae]] may be seen in chronic [[corticosteroid]] use; signifying a risk factor for [[osteoporosis]] | *Central [[obesity]] and [[striae]] may be seen in chronic [[corticosteroid]] use; signifying a risk factor for [[osteoporosis]].<ref name="pmid9648484" /> | ||
=== Back === | === Back === | ||
* Point [[tenderness]] may be seen in case of [[fractures]] | * Point [[tenderness]] may be seen in case of [[fractures]]. | ||
* Stooped back, "Dowager's hump"; caused by compression of [[vertebrae]] | * Stooped back, "Dowager's hump"; caused by compression of [[vertebrae]].<ref name="pmid218763362">{{cite journal |vauthors=Weale R, Weale M |title=The Dowager's hump: an early start? |journal=Gerontology |volume=58 |issue=3 |pages=212–5 |year=2012 |pmid=21876336 |doi=10.1159/000329828 |url=}}</ref> | ||
* [[Kyphoscoliosis]] may be seen | * [[Kyphoscoliosis]] may be seen.<ref name="pmid218763362" /> | ||
* Shortened [[spinal column]]; caused by compression of [[vertebrae]] | * 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]] | * [[Buffalo hump]] (Large fat pad at the back of neck) may be present due to chronic [[corticosteroid]] use; signifying a risk factor for [[osteoporosis]].<ref name="pmid9648484" /> | ||
=== Genitourinary === | === Genitourinary === | ||
* [[Hypogonadism]] may be evident; signifying a risk factor for [[osteoporosis]] | * [[Hypogonadism]] may be evident; signifying a risk factor for [[osteoporosis]].<ref name="pmid16985910">{{cite journal| author=Dupree K, Dobs A| title=Osteopenia and male hypogonadism. | journal=Rev Urol | year= 2004 | volume= 6 Suppl 6 | issue= | pages= S30-4 | pmid=16985910 | doi= | pmc=1472878 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16985910 }}</ref> | ||
===Extremities=== | ===Extremities=== | ||
*[[Fracture]] or previously healed [[fractures]] may be present | *[[Fracture]] or previously healed [[fractures]] may be present. | ||
*Peripheral [[Muscle-plate|muscle]] [[atrophy]] may be present with chronic [[corticosteroid]] use; signifying a risk factor for [[osteoporosis]] | *Peripheral [[Muscle-plate|muscle]] [[atrophy]] may be present with chronic [[corticosteroid]] use; signifying a risk factor for [[osteoporosis]].<ref name="pmid9648484" /> | ||
==References== | ==References== | ||
Revision as of 19:31, 15 August 2017
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Osteoporosis Microchapters |
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Osteoporosis physical examination On the Web |
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American Roentgen Ray Society Images of Osteoporosis physical examination |
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Risk calculators and risk factors for Osteoporosis physical examination |
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
Physical examination of patients with osteoporosis is usually remarkable for bone pain. 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
All vital signs (i.e., blood pressure, pulse rate, respiratory rate, and temperature) are normal in osteoporosis.
Skin
- Normal
- Striae may be present, if there is chronic corticosteroid use; signifying a risk factor for osteoporosis.[1]
HEENT
- Normal
- Characteristic moon-like face (i.e., round "puffy" face) may be present with chronic corticosteroid use; signifying a risk factor for osteoporosis.[1]
Neck
- Thyromegaly may be present in hyperthyroidism.[2]
Abdomen
- Hepatomegaly usually absent
- Hepatomegaly may be found due to hemochromatosis or alcoholism; both signifying risk factors for osteoporosis.[3]
- Central obesity and striae may be seen in chronic corticosteroid use; signifying a risk factor for osteoporosis.[1]
Back
- Point tenderness may be seen in case of fractures.
- Stooped back, "Dowager's hump"; caused by compression of vertebrae.[4]
- Kyphoscoliosis may be seen.[4]
- 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.[1]
Genitourinary
- Hypogonadism may be evident; signifying a risk factor for osteoporosis.[5]
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.[1]
References
- ↑ 1.0 1.1 1.2 1.3 1.4 Tomita A (1998). "[Glucocorticoid-induced osteoporosis--mechanisms and preventions]". Nippon Rinsho (in Japanese). 56 (6): 1574–8. PMID 9648484.
- ↑ Dhanwal DK (2011). "Thyroid disorders and bone mineral metabolism". Indian J Endocrinol Metab. 15 (Suppl 2): S107–12. doi:10.4103/2230-8210.83339. PMC 3169869. PMID 21966645.
- ↑ Linguraru MG, Sandberg JK, Jones EC, Petrick N, Summers RM (2012). "Assessing hepatomegaly: automated volumetric analysis of the liver". Acad Radiol. 19 (5): 588–98. doi:10.1016/j.acra.2012.01.015. PMC 3319283. PMID 22361033.
- ↑ 4.0 4.1 Weale R, Weale M (2012). "The Dowager's hump: an early start?". Gerontology. 58 (3): 212–5. doi:10.1159/000329828. PMID 21876336.
- ↑ Dupree K, Dobs A (2004). "Osteopenia and male hypogonadism". Rev Urol. 6 Suppl 6: S30–4. PMC 1472878. PMID 16985910.