Spina bifida physical examination

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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]

Physical Examination

• Physical examination of patients with spina bifida may be remarkable for:

• Spinal area discoloration or birthmarks may be the only sign in the newborns with spina bifida occulta
• Protrusions in the lumbar spine
• Dimples in the lumbar spine
• Hair patch along the spine

• Hydrocephalus signs may be present:
  • Enlarging head
  • Bulging fontanelle
  • Enlarged scalp veins
  • Cranial bones suture diastasis
  • Positive Macewen sign
• Paralysis
• Sensation problems
• Scoliosis
• Pressure ulcers
• Learning disabilities

Vital Signs

• Most patients with spina bifida have normal vital signs.

Skin

• Skin examination of patients with spina bifida is usually remarkable for:
  • Spinal area discoloration or birthmarks may be the only sign in the newborns with spina bifida occulta
  • Protrusions in the lumbar spine
  • Dimples in the lumbar spine
  • Hair patch along the spine

HEENT

• HEENT examination of patients with spina bifida is usually remarkable for:

• Enlarging head
• Bulging fontanelle
• Enlarged scalp veins
• Cranial bones suture diastasis
• Positive Macewen sign

Lungs

• Pulmonary examination of patients with spina bifida is usually normal.

Heart

• Cardiovascular examination of patients with spina bifida is usually normal but congenital anomalies of the spine have been associated with malformations of the cardiovascular systems.

Abdomen

• Abdominal examination of patients with spina bifida is usually normal.

Genitourinary

• Congenital anomalies of the spine may be associated with malformations of the genitourinary system,.

Neuromuscular

Neuromuscular examination of patients with spina bifida may be remarkable for:

• Paralysis
• Sensation problems
• Scoliosis
• Pressure ulcers
• Learning disabilities
• Clonus
• Hyperreflexia or hyporeflexia
• Positive (abnormal) Babinski unilaterally
• Muscle rigidity
• Muscle weakness unilaterally or bilaterally
• Abnormal gait
• Dysmetria

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