Polyarteritis nodosa physical examination: Difference between revisions
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{{Polyarteritis nodosa}} | {{Polyarteritis nodosa}} | ||
{{CMG}}; {{AE}} {{CZ}}; [[User:Haritha|Haritha Machavarapu, M.B.B.S.]] | * {{CMG}}; {{AE}} {{CZ}}; [[User:Haritha|Haritha Machavarapu, M.B.B.S.]] | ||
* Overview | |||
* Physical Examination | |||
* Physical examination plays an important role in diagnosing PAN. | * Physical examination plays an important role in diagnosing PAN. | ||
* Arteritis can be suspected with the presence of multiple mononeuropathies. | * Arteritis can be suspected with the presence of multiple mononeuropathies. | ||
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** Abdominal tenderness | ** Abdominal tenderness | ||
** Gastro-intestinal bleeding | ** Gastro-intestinal bleeding | ||
=== Genitourinary === | |||
* Genitourinary examination of patients with PAN reveals testicular tenderness on palpation. | |||
=== Neuromuscular === | |||
* Neuromuscular examination of patients with PAN shows:<ref name="pmid1979706">{{cite journal |vauthors=Rosenberg MR, Parshley M, Gibson S, Wernick R |title=Central nervous system polyarteritis nodosa |journal=West. J. Med. |volume=153 |issue=5 |pages=553–6 |date=November 1990 |pmid=1979706 |pmc=1002622 |doi= |url=}}</ref> | |||
** Sensory and/or motor neuropathies | |||
** Mononeuritis multiplex<ref name="pmid11723762">{{cite journal |vauthors=Griffin JW |title=Vasculitic neuropathies |journal=Rheum. Dis. Clin. North Am. |volume=27 |issue=4 |pages=751–60, vi |date=November 2001 |pmid=11723762 |doi= |url=}}</ref> | |||
*** Asymmetrical | |||
*** Nerves that are usually involved include: ulnar, radial,peroneal etc. | |||
==References== | ==References== | ||
Revision as of 17:19, 21 May 2018
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- Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Haritha Machavarapu, M.B.B.S.
- Overview
- Physical Examination
- Physical examination plays an important role in diagnosing PAN.
- Arteritis can be suspected with the presence of multiple mononeuropathies.
- Signs of ischemia such as extremity ischemia, hypertension and renovascular disease can help in diagnosing PAN.
Skin
- Skin examination of patients with PAN can show:[1]
- Livedo reticularis
- Ulcerations
- Ulcers can be seen on the lower extremeties
- Digital ischemia
- Splinter hemorrages can be seen.
- Gangrene can also be seen.
- Nodules
- Nodules are a rare finding.
- Most commonly seen on lower extremity.
HEENT
- PAN may present with ophthalmologic symptoms like:
- Retinal vasculitis
- Retinal detachment
- Cotton-wool spots
Heart
- Cardiovascular examination of patients with PAN shows:
- Hypertension
- Tachycardia
- Pericardial friction rub
- Arrhythmias
- Congestive heart failure
Abdomen
- Abdominal examination of patients with PAN shows:[2]
- Abdominal tenderness
- Gastro-intestinal bleeding
Genitourinary
- Genitourinary examination of patients with PAN reveals testicular tenderness on palpation.
Neuromuscular
- Neuromuscular examination of patients with PAN shows:[3]
- Sensory and/or motor neuropathies
- Mononeuritis multiplex[4]
- Asymmetrical
- Nerves that are usually involved include: ulnar, radial,peroneal etc.
References
- ↑ Stone JH (October 2002). "Polyarteritis nodosa". JAMA. 288 (13): 1632–9. PMID 12350194.
- ↑ Levine SM, Hellmann DB, Stone JH (April 2002). "Gastrointestinal involvement in polyarteritis nodosa (1986-2000): presentation and outcomes in 24 patients". Am. J. Med. 112 (5): 386–91. PMID 11904113.
- ↑ Rosenberg MR, Parshley M, Gibson S, Wernick R (November 1990). "Central nervous system polyarteritis nodosa". West. J. Med. 153 (5): 553–6. PMC 1002622. PMID 1979706.
- ↑ Griffin JW (November 2001). "Vasculitic neuropathies". Rheum. Dis. Clin. North Am. 27 (4): 751–60, vi. PMID 11723762.