Growth hormone deficiency physical examination: Difference between revisions
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===Appearance of the Patient=== | ===Appearance of the Patient=== | ||
*Patients with growth hormone deficiency usually look tired and less energetic than normal subjects of the same age with infantile with doll-like body shape. In adults, increased lean [[body mass]] causes [[weight gain]], especially around the [[waist]]. | *Patients with growth hormone deficiency usually look tired and less energetic than normal subjects of the same age with infantile with doll-like body shape. In adults, increased lean [[body mass]] causes [[weight gain]], especially around the [[waist]].<ref name="pmid25070016">{{cite journal| author=Fukuda I, Hizuka N, Muraoka T, Ichihara A| title=Adult growth hormone deficiency: current concepts. | journal=Neurol Med Chir (Tokyo) | year= 2014 | volume= 54 | issue= 8 | pages= 599-605 | pmid=25070016 | doi= | pmc=4533495 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25070016 }}</ref> | ||
=== Back === | === Back === | ||
[[Osteoporosis]] and tenderness of the [[Lumbar spine|lumbar spines]] are higher in patients compared with normal subjects. | * [[Osteoporosis]] and tenderness of the [[Lumbar spine|lumbar spines]] are higher in patients compared with normal subjects.<ref name="pmid22157400">{{cite journal| author=Stanley T| title=Diagnosis of growth hormone deficiency in childhood. | journal=Curr Opin Endocrinol Diabetes Obes | year= 2012 | volume= 19 | issue= 1 | pages= 47-52 | pmid=22157400 | doi=10.1097/MED.0b013e32834ec952 | pmc=3279941 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22157400 }}</ref> | ||
===Vital Signs=== | ===Vital Signs=== | ||
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===Neck=== | ===Neck=== | ||
*[[Carotid bruits]] may be auscultated unilaterally/bilaterally due to high rate of [[atherosclerosis]]. | *[[Carotid bruits]] may be auscultated unilaterally/bilaterally due to the high rate of [[atherosclerosis]].<ref name="pmid26550626" /> | ||
===Abdomen=== | ===Abdomen=== | ||
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===Genitourinary=== | ===Genitourinary=== | ||
*[[Cryptorchidism]] and [[micropenis]] in infants | *[[Cryptorchidism]] and [[micropenis]] in infants<ref name="pmid27974187" /> | ||
*[[Delayed puberty]] in children | *[[Delayed puberty]] in children<ref name="pmid26550626">{{cite journal| author=Nielsen J, Jensen RB, Afdeling AJ| title=[Growth hormone deficiency in children]. | journal=Ugeskr Laeger | year= 2015 | volume= 177 | issue= 26 | pages= 1260-3 | pmid=26550626 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26550626 }}</ref> | ||
===Neuromuscular=== | ===Neuromuscular=== | ||
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*[[Jaundice]] in neonates | *[[Jaundice]] in neonates | ||
*Pitting/non-pitting [[edema]] | *Pitting/non-pitting [[edema]] | ||
*[[Muscle atrophy]] | *[[Muscle atrophy]]<ref name="pmid27974187">{{cite journal| author=Chinoy A, Murray PG| title=Diagnosis of growth hormone deficiency in the paediatric and transitional age. | journal=Best Pract Res Clin Endocrinol Metab | year= 2016 | volume= 30 | issue= 6 | pages= 737-747 | pmid=27974187 | doi=10.1016/j.beem.2016.11.002 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27974187 }}</ref> | ||
==References== | ==References== |
Revision as of 16:00, 27 September 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammed Abdelwahed M.D[2]
Overview
Patients with growth hormone deficiency usually look tired and less energetic than normal subjects. Extremities show Clubbing, muscle atrophy, neonatal jaundice, neonatal cyanosis. Head may show infantile facies, delayed dentition, and brittle hair. Children may show hyporeflexia and delayed puberty.
Physical Examination
Appearance of the Patient
- Patients with growth hormone deficiency usually look tired and less energetic than normal subjects of the same age with infantile with doll-like body shape. In adults, increased lean body mass causes weight gain, especially around the waist.[1]
Back
- Osteoporosis and tenderness of the lumbar spines are higher in patients compared with normal subjects.[2]
Vital Signs
- Hypothermia may be present especially if associated with hypothyroidism.
Skin
HEENT
- Head may include infantile facies, delayed dentition, and brittle hair.
Neck
- Carotid bruits may be auscultated unilaterally/bilaterally due to the high rate of atherosclerosis.[3]
Abdomen
- Abdominal distention due to increased lean body mass
Genitourinary
- Cryptorchidism and micropenis in infants[4]
- Delayed puberty in children[3]
Neuromuscular
- Hyporeflexia
- Muscle weakness bilaterally
Extremities
- Clubbing
- Cyanosis in neonates
- Jaundice in neonates
- Pitting/non-pitting edema
- Muscle atrophy[4]
References
- ↑ Fukuda I, Hizuka N, Muraoka T, Ichihara A (2014). "Adult growth hormone deficiency: current concepts". Neurol Med Chir (Tokyo). 54 (8): 599–605. PMC 4533495. PMID 25070016.
- ↑ Stanley T (2012). "Diagnosis of growth hormone deficiency in childhood". Curr Opin Endocrinol Diabetes Obes. 19 (1): 47–52. doi:10.1097/MED.0b013e32834ec952. PMC 3279941. PMID 22157400.
- ↑ 3.0 3.1 Nielsen J, Jensen RB, Afdeling AJ (2015). "[Growth hormone deficiency in children]". Ugeskr Laeger. 177 (26): 1260–3. PMID 26550626.
- ↑ 4.0 4.1 Chinoy A, Murray PG (2016). "Diagnosis of growth hormone deficiency in the paediatric and transitional age". Best Pract Res Clin Endocrinol Metab. 30 (6): 737–747. doi:10.1016/j.beem.2016.11.002. PMID 27974187.