Rhabdomyosarcoma physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; {AE}} Shadan Mehraban, M.D.[2]
Overview
Physical Examination
- Physical examination findings depend on the tumor origin and the presence or absence of metastases.[1]
- Physical examination of patients with rhabdomyosarcoma is usually remarkable for nontender, palpable mass.
Appearance of the Patient
- Patients with rhabdomyosarcoma usually have normal appearance.
Vital Signs
- Fever may be present
Skin
- Skin examination of patients with Rhabdomyosarcoma may be erythmatous.
HEENT
- HEENT examination of patients with rhabdomyosarcoma depends on tumor site.
- Abnormal physical examination findings are:[2]
- Proptosis
- Ophtalmoplasia
- Dysconjugate gaze
- Presence of localized nontender enlarging mass
Neck
- Neck examination of patients with rhabdomyosarcoma may be presence of nontender enlarging mass.
Lungs
- Pulmonary examination of patients with metastatic rhabdomyosarcoma may be infavor of pleural effusion.
Heart
- Cardiovascular examination of patients with rhabdomyosarcoma is usually normal.
Abdomen
- Abdominal examination of patients with is usually normal.
OR
- Abdominal distension
- Abdominal tenderness in the right/left upper/lower abdominal quadrant
- Rebound tenderness (positive Blumberg sign)
- A palpable abdominal mass in the right/left upper/lower abdominal quadrant
- Guarding may be present
- Hepatomegaly / splenomegaly / hepatosplenomegaly
- Additional findings, such as obturator test, psoas test, McBurney point test, Murphy test
Back
- Back examination of patients with [disease name] is usually normal.
OR
- Point tenderness over __ vertebrae (e.g. L3-L4)
- Sacral edema
- Costovertebral angle tenderness bilaterally/unilaterally
- Buffalo hump
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
- ↑ Maurer HM, Beltangady M, Gehan EA, Crist W, Hammond D, Hays DM; et al. (1988). "The Intergroup Rhabdomyosarcoma Study-I. A final report". Cancer. 61 (2): 209–20. PMID 3275486.
- ↑ Rao AA, Naheedy JH, Chen JY, Robbins SL, Ramkumar HL (2013). "A clinical update and radiologic review of pediatric orbital and ocular tumors". J Oncol. 2013: 975908. doi:10.1155/2013/975908. PMC 3610355. PMID 23577029.