Undifferentiated connective tissue disease physical examination: Difference between revisions

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==Overview==
==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==
*The presence of following findings on physical examination is highly suggestive of undifferentiated connective tissue disease(UCTD):<ref name="pmid12846049">{{cite journal |vauthors=Bodolay E, Csiki Z, Szekanecz Z, Ben T, Kiss E, Zeher M, Szücs G, Dankó K, Szegedi G |title=Five-year follow-up of 665 Hungarian patients with undifferentiated connective tissue disease (UCTD) |journal=Clin. Exp. Rheumatol. |volume=21 |issue=3 |pages=313–20 |date=2003 |pmid=12846049 |doi= |url=}}</ref>
*The presence of following findings on physical examination is highly suggestive of undifferentiated connective tissue disease(UCTD):<ref name="pmid12846049">{{cite journal |vauthors=Bodolay E, Csiki Z, Szekanecz Z, Ben T, Kiss E, Zeher M, Szücs G, Dankó K, Szegedi G |title=Five-year follow-up of 665 Hungarian patients with undifferentiated connective tissue disease (UCTD) |journal=Clin. Exp. Rheumatol. |volume=21 |issue=3 |pages=313–20 |date=2003 |pmid=12846049 |doi= |url=}}</ref>
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* [[Lymphadenopathy]] (describe location, size, tenderness, mobility, and symmetry)
* [[Lymphadenopathy]] (describe location, size, tenderness, mobility, and symmetry)
===Lungs===
===Lungs===
* Asymmetric chest expansion / Decreased chest expansion
* Rhonchi
*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
*[[Wheezing]] may be present
*[[Egophony]] present/absent
*[[Pleural friction rub]]
*[[Bronchophony]] present/absent
*Normal/reduced [[tactile fremitus]]


===Heart===
===Heart===
* Cardiovascular examination of patients with [disease name] is usually normal.
* [[Pericardial friction rub]]
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]]
*[[Heart sounds#First heart tone S1, the "lub"(components M1 and T1)|S1]]
*[[Heart sounds#Second heart tone S2 the "dub"(components A2 and P2)|S2]]
*[[Heart sounds#Third heart sound S3|S3]]
*[[Heart sounds#Fourth heart sound S4|S4]]
*[[Heart sounds#Summation Gallop|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===
===Abdomen===
Abdominal examination of patients with [disease name] is usually normal.
OR
*[[Abdominal distention]]
*[[Abdominal tenderness]] in the right/left upper/lower abdominal quadrant  
*[[Abdominal tenderness]] in the right/left upper/lower abdominal quadrant  
*[[Rebound tenderness]] (positive Blumberg sign)
*[[Rebound tenderness]]  
*A palpable abdominal mass in the right/left upper/lower abdominal quadrant
*[[Hepatomegaly]]  
*Guarding may be present
*[[Hepatomegaly]] / [[splenomegaly]] / [[hepatosplenomegaly]]
*Additional findings, such as obturator test, psoas test, McBurney point test, Murphy test


===Back===
===Back===
* Back examination of patients with [disease name] is usually normal.
*Tenderness over lumbar vertebrae can occur
OR
*Sacral [[edema]] may be seen
*Point tenderness over __ vertebrae (e.g. L3-L4)
*Sacral edema
*Costovertebral angle tenderness bilaterally/unilaterally
*Buffalo hump


===Genitourinary===
===Genitourinary===

Revision as of 01:11, 30 April 2018

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

Overview

Physical Examination

  • The presence of following findings on physical examination is highly suggestive of undifferentiated connective tissue disease(UCTD):[1]

Appearance of the Patient

  • Patients with UCTD usually appear [general appearance].

Vital Signs

Skin

HEENT

Neck

  • Lymphadenopathy (describe location, size, tenderness, mobility, and symmetry)

Lungs

Heart

Abdomen

Back

  • Tenderness over lumbar vertebrae can occur
  • Sacral edema may be seen

Genitourinary

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

OR

  • A pelvic/adnexal mass may be palpated
  • Inflamed mucosa
  • Clear/(color), foul-smelling/odorless penile/vaginal discharge

Neuromuscular

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

OR

  • Patient is usually oriented to persons, place, and time
  • Altered mental status
  • Glasgow coma scale is ___ / 15
  • Clonus may be present
  • Hyperreflexia / hyporeflexia / areflexia
  • Positive (abnormal) Babinski / plantar reflex unilaterally/bilaterally
  • Muscle rigidity
  • Proximal/distal muscle weakness unilaterally/bilaterally
  • ____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
  • Unilateral/bilateral upper/lower extremity weakness
  • Unilateral/bilateral sensory loss in the upper/lower extremity
  • Positive straight leg raise test
  • Abnormal gait (describe gait: e.g. ataxic (cerebellar) gait / steppage gait / waddling gait / choeiform gait / Parkinsonian gait / sensory gait)
  • Positive/negative Trendelenburg sign
  • Unilateral/bilateral tremor (describe tremor, e.g. at rest, pill-rolling)
  • Normal finger-to-nose test / Dysmetria
  • Absent/present dysdiadochokinesia (palm tapping test)

Extremities

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

OR

  • Clubbing
  • Cyanosis
  • Pitting/non-pitting edema of the upper/lower extremities
  • Muscle atrophy
  • Fasciculations in the upper/lower extremity

References

  1. ↑ Bodolay E, Csiki Z, Szekanecz Z, Ben T, Kiss E, Zeher M, Szücs G, Dankó K, Szegedi G (2003). "Five-year follow-up of 665 Hungarian patients with undifferentiated connective tissue disease (UCTD)". Clin. Exp. Rheumatol. 21 (3): 313–20. PMID 12846049.

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