Undifferentiated connective tissue disease physical examination

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

Physical Examination

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

Appearance of the Patient

• Patients with UCTD usually appear [general appearance].

Vital Signs

• Low-grade fever

Skin

• Raynaud's phenomenon
• Rash
• Erythema nodosum

HEENT

• Conjunctivitis
• Uveitis
• Keratoconjunctivitis sicca
• Dry-mouth

Neck

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

Lungs

• Rhonchi
• Wheezing may be present
• Pleural friction rub

Heart

• Pericardial friction rub

Abdomen

• Abdominal tenderness in the right/left upper/lower abdominal quadrant
• Rebound tenderness
• Hepatomegaly

Back

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

Genitourinary

• Rashes can be seen

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