Osteoporosis physical examination: Difference between revisions
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* [[Kyphoscoliosis]] may be seen.<ref name="pmid218763362" /> | * [[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 | * [[Buffalo hump]] (Large fat pad at the back of neck) may be present due to chronic [[corticosteroid]] use.<ref name="pmid9648484" /> | ||
=== Genitourinary === | === Genitourinary === | ||
Revision as of 16:06, 17 October 2017
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Osteoporosis Microchapters |
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Diagnosis |
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Treatment |
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Medical Therapy |
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Case Studies |
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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 leads to a fracture. Fractures can be divided into acute and chronic ones; involving the 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 if they already encountered a fracture. Osteoporosis is generally asymptomatic during initial years; until the bone mass loss results in a fracture. These fractures could be divided into acute and chronic ones; mostly involving the 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 is most likely found to be be an elderly, thin, asian or caucasian female of short stature.
- If they have osteoporosis due to chronic corticosteroid use, they may present with features 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 (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.[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 may be seen in chronic corticosteroid use.[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.[1]
Genitourinary
Extremities
- Fracture or previously healed fractures may be present.
- Peripheral muscle atrophy may be present with chronic corticosteroid use.[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.