Granulomatosis with polyangiitis physical examination: Difference between revisions
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===Neck=== | ===Neck=== | ||
* Neck examination of patients with granulomatosis with polyangiitis is usually normal | * Neck examination of patients with granulomatosis with polyangiitis is usually normal. | ||
===Lungs=== | ===Lungs=== | ||
* Asymmetric chest expansion / Decreased chest expansion | * Asymmetric chest expansion / Decreased chest expansion | ||
| Line 58: | Line 58: | ||
*[[Heart sounds#Second heart tone S2 the "dub"(components A2 and P2)|S2]] | *[[Heart sounds#Second heart tone S2 the "dub"(components A2 and P2)|S2]] | ||
===Abdomen=== | ===Abdomen=== | ||
*[[Abdominal tenderness]] may be present<ref name="pmid15758841">{{cite journal |vauthors=Pagnoux C, Mahr A, Cohen P, Guillevin L |title=Presentation and outcome of gastrointestinal involvement in systemic necrotizing vasculitides: analysis of 62 patients with polyarteritis nodosa, microscopic polyangiitis, Wegener granulomatosis, Churg-Strauss syndrome, or rheumatoid arthritis-associated vasculitis |journal=Medicine (Baltimore) |volume=84 |issue=2 |pages=115–28 |date=March 2005 |pmid=15758841 |doi= |url=}}</ref> | |||
*[[Abdominal tenderness]] in | |||
*Guarding may be present | *Guarding may be present | ||
===Back=== | ===Back=== | ||
* Back examination of patients with | * Back examination of patients with granulomatosis with polyangiitis is usually normal. | ||
===Genitourinary=== | ===Genitourinary=== | ||
* Genitourinary examination of patients with [disease name] is usually normal. | * Genitourinary examination of patients with [disease name] is usually normal. | ||
| Line 76: | Line 68: | ||
*A pelvic/adnexal mass may be palpated | *A pelvic/adnexal mass may be palpated | ||
*Inflamed mucosa | *Inflamed mucosa | ||
===Neuromuscular=== | ===Neuromuscular=== | ||
*Patient is usually oriented to persons, place, and time | *Patient is usually oriented to persons, place, and time | ||
*[[Mononeuritis multiplex]]- Loss of sensory and motor functions | *[[Mononeuritis multiplex]]- Loss of sensory and motor functions | ||
===Extremities=== | ===Extremities=== | ||
* Extremities examination of patients with | * Extremities examination of patients with granulomatosis with polyangiitis is usually normal. | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 20:04, 4 April 2018
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Granulomatosis with polyangiitis Microchapters |
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Differentiating Granulomatosis with polyangiitis from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Ali Poyan Mehr, M.D. [2]Associate Editor(s)-in-Chief: Krzysztof Wierzbicki M.D. [3]
Overview
A complete medical history and a comprehensive renal, pulmonary, and ENT examination must be preformed to help identify and properly diagnose Granulomatosis with polyangiitis from other diseases.
- Cranial nerve paralysis
Physical Examination
- Physical examination of patients with Granulomatosis with polyangiitis is usually remarkable for:[1][2]
Vital Signs
- They usually have normal vital signs until infected.
Skin
The skin findings are seen in 14% of patients:[3]
- Ulcerations
- Palpable purpura
- Subcutaneous nodules
HEENT
- Scleritis
- Keratitis
- Uveitis
- Conjunctivitis
- Proptosis
- Xanthelasma
- Purulent exudate from the nares
- Sinusitis
- Saddle nose deformity
- Otitis Media
- Hearing acuity may be reduced[1]
- Weber test may be abnormal
- Rinne test may be positive
- Gingival hyperplasia or necrotizing gingivitis[4] can be seen
Neck
- Neck examination of patients with granulomatosis with polyangiitis is usually normal.
Lungs
- Asymmetric chest expansion / Decreased chest expansion
- Lungs are hypo/hyperresonant
- Fine/coarse crackles upon auscultation of the lung bases/apices unilaterally/bilaterally
- Rhonchi
- Vesicular breath sounds / Distant breath sounds
- Expiratory/inspiratory wheezing with normal / delayed expiratory phase
- Wheezing may be present
- Egophony present/absent
- Bronchophony present/absent
- Normal/reduced tactile fremitus
- Atelectasis
- Pleural effusion
Heart
Abdomen
- Abdominal tenderness may be present[5]
- Guarding may be present
Back
- Back examination of patients with granulomatosis with polyangiitis is usually normal.
Genitourinary
- Genitourinary examination of patients with [disease name] is usually normal.
OR
- A pelvic/adnexal mass may be palpated
- Inflamed mucosa
Neuromuscular
- Patient is usually oriented to persons, place, and time
- Mononeuritis multiplex- Loss of sensory and motor functions
Extremities
- Extremities examination of patients with granulomatosis with polyangiitis is usually normal.
References
- ↑ 1.0 1.1 Seo P, Stone JH (July 2004). "The antineutrophil cytoplasmic antibody-associated vasculitides". Am. J. Med. 117 (1): 39–50. doi:10.1016/j.amjmed.2004.02.030. PMID 15210387.
- ↑ Graves N (October 2006). "Wegener granulomatosis". Proc (Bayl Univ Med Cent). 19 (4): 342–4. PMC 1618758. PMID 17106496.
- ↑ Daoud MS, Gibson LE, DeRemee RA, Specks U, el-Azhary RA, Su WP (October 1994). "Cutaneous Wegener's granulomatosis: clinical, histopathologic, and immunopathologic features of thirty patients". J. Am. Acad. Dermatol. 31 (4): 605–12. PMID 8089286.
- ↑ Genuis K, Pewarchuk J (September 2014). "Granulomatosis with polyangiitis (Wegener's) as a necrotizing gingivitis mimic: a case report". J Med Case Rep. 8: 297. doi:10.1186/1752-1947-8-297. PMC 4168997. PMID 25196320.
- ↑ Pagnoux C, Mahr A, Cohen P, Guillevin L (March 2005). "Presentation and outcome of gastrointestinal involvement in systemic necrotizing vasculitides: analysis of 62 patients with polyarteritis nodosa, microscopic polyangiitis, Wegener granulomatosis, Churg-Strauss syndrome, or rheumatoid arthritis-associated vasculitis". Medicine (Baltimore). 84 (2): 115–28. PMID 15758841.