Scleroderma physical examination

Scleroderma Microchapters
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: M. Khurram Afzal, MD [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 scleroderma 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

• Vital signs of patients with scleroderma are usually normal

Skin

• Skin induration
• Skin fibrosis
• Telangiectasias
• Calcinosis

HEENT

• HEENT examination of patients with scleroderma is usually normal.

Neck

• Jugular venous distention maybe present suggesting right heart failure due to pulmonary hypertension.

Lungs

• Pulmonary examination of patients with scleroderma is usually normal.
• Inspiratory crackles upon auscultation of the lung are suggestive of interstitial lung disease.

Heart

• Right ventricular heave can be suggestive of pulmonary arterial hypertension (PAH)

Abdomen

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

OR

• Abdominal distention
• 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 scleroderma is usually normal.

Genitourinary

• Genitourinary examination of patients with scleroderma is usually normal.

Neuromuscular

• Neuromuscular examination of patients with scleroderma is usually normal.

Extremities

• Myopathy
• Ulceration of finger tips (ischemic)
• Contractures of finger flexion
• Raynaud's phenomenon
• Dilatation of nailfold capillaries
• Sclerodactyly