Sjögren's syndrome physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

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Overview

Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].

OR

Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].

OR

The presence of [finding(s)] on physical examination is diagnostic of [disease name].

OR

The presence of [finding(s)] on physical examination is highly suggestive of [disease name].

Physical Examination

• Physical examination of patients with [disease name] is usually normal.

OR

• Physical examination of patients with [disease name] is usually remarkable for:[finding 1], [finding 2], and [finding 3].
• The presence of [finding(s)] on physical examination is diagnostic of [disease name].
• The presence of [finding(s)] on physical examination is highly suggestive of [disease name].

Appearance of the Patient

• Patients with [disease name] usually appear [general appearance].

Vital Signs

• High-grade / low-grade fever
• Hypothermia / hyperthermia may be present
• Tachycardia with regular pulse or (ir)regularly irregular pulse
• Bradycardia with regular pulse or (ir)regularly irregular pulse
• Tachypnea / bradypnea
• Kussmal respirations may be present in _____ (advanced disease state)
• Weak/bounding pulse / pulsus alternans / paradoxical pulse / asymmetric pulse
• High/low blood pressure with normal pulse pressure / wide pulse pressure / narrow pulse pressure

Skin

• Dryness of the skin
• Scaling
• Partial or complete loss of sweating
• Dry, sparse, and brittle hair may be present
• Diffuse alopecia may involve the scalp, limbs, axillae, or pubis
• Nail folds may show capillaroscopic abnormalities
• Nonpalpable or palpable, vasculitic purpura, with lesions that are typically 2-3 mm in diameter and located on the lower extremities may be present
• Annular erythema with scales, localized especially on the face and neck

HEENT

• Mucous dryness
• Red, smooth, and dry tongue
• Dental caries
• Parotid duct narrowing
• Red, dry, and scaly lips
• Cracks at the corners of the mouth
• Chronic oral candidiasis
• Atrophic changes in the mucous membranes of the upper respiratory tract

Neck

• Bilateral parotid gland enlargement

Lungs

• Bibasilar rales nt
• Wheezing may be present

Heart

• Cardiovascular examination of patients with [disease name] is usually normal.

OR

• Chest tenderness upon palpation
• PMI within 2 cm of the sternum (PMI) / Displaced point of maximal impulse (PMI) suggestive of ____
• Heave / thrill
• Friction rub
• S1
• S2
• S3
• S4
• Gallops
• A high/low grade early/late systolic murmur / diastolic murmur best heard at the base/apex/(specific valve region) may be heard using the bell/diaphgram of the otoscope

Abdomen

• Splenomegaly

Back

• Back examination of patients with Sjögren's syndrome is usually normal.

Genitourinary

• Irritated bladder
• Suprapubic pain
• Atrophic changes in the vulva and vagin
• Dryness of the anal and rectal mucous membranes

Neuromuscular

• Patient is usually oriented to persons, place, and time.
• Glasgow coma scale is 15/15
• Paraparesis maybe present
• Paraplegia may be present

Extremities

• Symmetrical, polyarticular, inflammatory arthritis