Takayasu's arteritis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Farnaz Khalighinejad, MD [2]

Overview

A thorough physical examination is essential, with particular attention to peripheral pulses, blood pressure in all 4 extremities, ophthalmologic examination.

Physical Examination

A thorough physical examination is essential, with particular attention to:

• Peripheral pulses

• Blood pressure in all 4 extremities

• Ophthalmologic examination

Vital Signs

• Vital signs are with in normal limits.

Skin

• Erythema nodosum

• Ulcerating nodular lesions

HEENT

Ophthalmologic examination may show:

• Retinal ischemia
• Retinal hemorrhages
• Cotton-wool exudates
• Venous dilatation and beading
• Microaneurysms of peripheral retina
• Optic atrophy
• Vitreous hemorrhage
• Wreathlike peripapillary arteriovenous anastomoses (extremely rare)

Neck

• Neck examination of patients with Takayasu's arteritis is usually normal.

Lungs

• Pulmonary examination of patients with temporal arteritis is usually normal.

Heart

• Heart murmurs
  • Aortic regurgitation may result from aortic root dilation

Abdomen

• Abdominal examination of patients with Takayasu's arteritis is usually normal.

Back

• Back examination of patients with Takayasu's arteritis is usually normal.

Genitourinary

• Genitourinary examination of patients with Takayasu's arteritis is usually normal.

Neuromuscular

Involvement of the carotid and vertebral arteries causes decreased cerebral blood flow, leading to:

• Lightheadedness

• Vertigo

• Syncope

• Orthostasis

• Headaches

• Convulsions

• Strokes