Antiphospholipid syndrome physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Feham Tariq, MD [2]

Overview

Physical examination shows no pathognomonic physical findings of APS; however, abnormal features may be found on examination that are related to infarction or ischemia of the skin, viscera, or the central nervous system leading to cutaneous and neurological manifestations.

Physical Examination

Physical examination shows no pathognomonic physical findings of APS; however, abnormal features may be found on examination that are related to infarction or ischemia of the skin, viscera, or the central nervous system leading to cutaneous and neurological manifestations.

Appearance of the Patient

Patients with APS usually appear normal.

Vital Signs

Low-grade fever may be present in case of infectious cause of APS>\.

Cutaneous manifestations

Skin examination of patients with APS is usually positive for:

Venous thromboembolism
Livedo reticularis
Purpura
Superficial thrombophelibitis
Leg ulcers
Splinter hemorrhages
Gangrene of the distal extremities
Leg swelling

HEENT

Abnormal fundoscopic examination findings:

Retinal artery occlusion findings
Retinal vein thrombosis findings

Neck

Neck examination of patients with APS is usually normal.

Lungs

Pulmonary examination of patients with APS may show the following findings:

Tachypnea in case of pulmonary embolism.

Heart

Cardiovascular examination of patients with APS shows findings consistent with heart valve disease.
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

Abdominal tenderness in the lower abdominal quadrant in case of miscarriage or fetal loss.
Rebound tenderness
Guarding may be present

Back

Back examination of patients with APS is usually normal.

Genitourinary

Genitourinary examination of patients with APS is usually normal.

Neuromuscular

Neurological exam findings consistent with stroke or transient ischemic attack.
Migraine
Vascular dementia
Pre-eclampsia or eclampsia

References