Hyperparathyroidism physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[2]
Overview
Physical examination of patients with hyperparathyroidism is usually unremarkable. Patients may have physical findings due to severe hypercalcemia and other complications of hyperparathyroidism.
Physical Examination
- Physical examination of patients with hyperparathyroidism is usually unremarkable.[1]
- Patients may have physical findings due to severe hypercalcemia and other complications of hyperparathyroidism.[2]
Appearance of the Patient
- Patients with hyperparathyroidism usually appear well.
Vital Signs
- Patients with hypercalcemia and other complications may have:
- High blood pressure due to hypercalcemia and renal failure
Skin
- Persistent itching may be present due to renal failure
HEENT
- Patients with severe hypercalcemia may have:
- Band keratopathy (calcium precipitation in a horizontal band across the cornea in the palpebral aperture); may lead to vision impairment
Lungs
- Patients with hypercalcemia and other complications may have:
- Dyspnea due to fluid overload form renal failure
Cardiovasvular
- Patients with hypercalcemia and other complications may have:
- Palpitations due to arrhythmias
- Shortened QT interval
- Chest pain due to fluid overload form renal failure
- Rales and S3 due to fluid overload form renal failure
Abdomen
- Patients with hypercalcemia and other complications may have:
- Nausea and vomiting
- Anorexia
- Fecal impaction (from constipation)
- Epigastric pain and tenderness due to development of pancreatitis
- Flank pain and tenderness due to nephrolithiasis
Genitourinary
- Patients with severe hypercalcemia and other complications may have:
- Alteration in urinary habits
- Volume depletion
- Signs of renal failure
Neuromuscular
- Patient is usually oriented to persons, place, and time.
- Patients with severe hypercalcemia and other complications may have:
- Anxiety
- Fatigue and weakness due to renal failure
- Lethargy
- Sleep disturbances
- Muscle twitch and cramps
- Signs of depression
- Confusion
- Memory disturbances
- Hypotonia
- Hyporeflexia
- Paresis
- Coma
Extremities
- Swelling of feet and ankles due to renal failure
- Arthralgia due to bone resorption
References
- ↑ Pallan S, Khan A (2011). "Primary hyperparathyroidism: Update on presentation, diagnosis, and management in primary care". Can Fam Physician. 57 (2): 184–9. PMC 3038812. PMID 21321169.
- ↑ Mishra SK, Agarwal G, Kar DK, Gupta SK, Mithal A, Rastad J (2001). "Unique clinical characteristics of primary hyperparathyroidism in India". Br J Surg. 88 (5): 708–14. doi:10.1046/j.0007-1323.2001.01775.x. PMID 11350446.