Tabes Dorsalis physical examination

Tabes Dorsalis Microchapters
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Physical Examination

Physical examination may show:

• Damage to the spinal cord (myelopathy)
• Pupils that react abnormally to light
• Reduced or absent reflexes due to nerve damage

References

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Mohamadmostafa Jahansouz M.D.[2]

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 of patients with [disease name] is usually normal.

OR

• Physical examination of patients with [disease name] is usually remarkable for:[finding 1], [finding 2], and [finding 3].
• The presence of [finding(s)] on physical examination is diagnostic of [disease name].
• The presence of [finding(s)] on physical examination is highly suggestive of [disease name].

Appearance of the Patient

• Patients with [disease name] usually appear [general appearance].

Vital Signs

• Usually vital ital signs are normal in tabes dorsal.

Skin

• In patients with tabes dorsalis some granulomatous skin lesions which are one of the late manifestations of tertiary syphilis called gumma may be present. Gummas, are granulomatous reactions to long-term smoldering infection with Treponema pallidum and its residual antigens.
• Jaundice may be seen.

Tertiary syphilis gumma
Source:By NearEMPTiness (Wie Schönes Wissen schafft im MUT) [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons, rID: 51340

HEENT

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

OR

• Abnormalities of the head/hair may include ___
• Icteric sclera
• Nystagmus may be seen
• Extra-ocular movements may be abnormal
• Argyll Robertson pupils may be present
• Hearing acuity may be reduced

Neck

• Jugular venous distension may be seen
• Nontender, mobile, small, cervical lymphadenopathy may be present

Lungs

• In patients with tabes dorsalis some granulomatous lung lesions which are one of the late manifestations of tertiary syphilis called gumma may be present. Gummas, are granulomatous reactions to long-term smoldering infection with Treponema pallidum and its residual antigens.

• Asymmetric chest expansion may be seen
• Bilaterally coarse crackles upon auscultation of the lung may be present

Neuromuscular

• Patient is usually oriented to persons, place, and time
• Altered mental status may be present
• Clonus may be present
• Hhyporeflexia or areflexia may be seen
• Impaired balance bilateral Babinski's Reflex may be present
• Bilateral muscle weakness mostly in lower limbs may be seen
• Argyll Robertson pupils may be present
• Bilateral sensory loss in the extremity mostly in lower limbs may be seen
• Sensory ataxic gait is usually seen in patients with tabes dorsalis
• 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