Scleroderma physical examination
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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 scleroderma usually appear anxious. Physical examination of patients with scleroderma is usually remarkable for sclerodactyly, Raynaud's phenomenon, digital ulcers, skin fibrosis and telangiectasias.
Physical Examination
Physical examination of patients with scleroderma is usually remarkable for sclerodactyly, Raynaud's phenomenon, digital ulcers, skin fibrosis and telangiectasis.[1][2][3]
Appearance of the Patient
- Patients with scleroderma usually appear anxious
Vital Signs
- Vital signs of patients with scleroderma are usually normal
Skin
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.[8][3]
Heart
- Right ventricular heave can be suggestive of pulmonary arterial hypertension (PAH)
Abdomen
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[4]
- Ulceration of finger tips (ischemic)[5]
- Contractures of finger flexion
- Raynaud's phenomenon[10][3]
- Dilatation of nailfold capillaries[1][2]
- Sclerodactyly[1][2]
References
- ↑ 1.0 1.1 1.2 1.3 van den Hoogen F, Khanna D, Fransen J, Johnson SR, Baron M, Tyndall A, Matucci-Cerinic M, Naden RP, Medsger TA, Carreira PE, Riemekasten G, Clements PJ, Denton CP, Distler O, Allanore Y, Furst DE, Gabrielli A, Mayes MD, van Laar JM, Seibold JR, Czirjak L, Steen VD, Inanc M, Kowal-Bielecka O, Müller-Ladner U, Valentini G, Veale DJ, Vonk MC, Walker UA, Chung L, Collier DH, Ellen Csuka M, Fessler BJ, Guiducci S, Herrick A, Hsu VM, Jimenez S, Kahaleh B, Merkel PA, Sierakowski S, Silver RM, Simms RW, Varga J, Pope JE (November 2013). "2013 classification criteria for systemic sclerosis: an American college of rheumatology/European league against rheumatism collaborative initiative". Ann. Rheum. Dis. 72 (11): 1747–55. doi:10.1136/annrheumdis-2013-204424. PMID 24092682.
- ↑ 2.0 2.1 2.2 2.3 Pope JE, Johnson SR (August 2015). "New Classification Criteria for Systemic Sclerosis (Scleroderma)". Rheum. Dis. Clin. North Am. 41 (3): 383–98. doi:10.1016/j.rdc.2015.04.003. PMID 26210125.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 Hudson M, Fritzler MJ, Baron M (May 2010). "Systemic sclerosis: establishing diagnostic criteria". Medicine (Baltimore). 89 (3): 159–65. doi:10.1097/MD.0b013e3181dde28d. PMID 20453602.
- ↑ 4.0 4.1 Shah AA, Wigley FM (April 2013). "My approach to the treatment of scleroderma". Mayo Clin. Proc. 88 (4): 377–93. doi:10.1016/j.mayocp.2013.01.018. PMC 3666163. PMID 23541012.
- ↑ 5.0 5.1 Krieg T, Takehara K (June 2009). "Skin disease: a cardinal feature of systemic sclerosis". Rheumatology (Oxford). 48 Suppl 3: iii14–8. doi:10.1093/rheumatology/kep108. PMID 19487217.
- ↑ Abignano G, Del Galdo F (March 2014). "Quantitating skin fibrosis: innovative strategies and their clinical implications". Curr Rheumatol Rep. 16 (3): 404. doi:10.1007/s11926-013-0404-5. PMID 24442715.
- ↑ Steen VD, Ziegler GL, Rodnan GP, Medsger TA (February 1984). "Clinical and laboratory associations of anticentromere antibody in patients with progressive systemic sclerosis". Arthritis Rheum. 27 (2): 125–31. PMID 6607734.
- ↑ Cappelli S, Bellando Randone S, Camiciottoli G, De Paulis A, Guiducci S, Matucci-Cerinic M (September 2015). "Interstitial lung disease in systemic sclerosis: where do we stand?". Eur Respir Rev. 24 (137): 411–9. doi:10.1183/16000617.00002915. PMID 26324802.
- ↑ Shreiner AB, Murray C, Denton C, Khanna D (2016). "Gastrointestinal Manifestations of Systemic Sclerosis". J Scleroderma Relat Disord. 1 (3): 247–256. doi:10.5301/jsrd.5000214. PMC 5267349. PMID 28133631.
- ↑ Wigley FM (September 2002). "Clinical practice. Raynaud's Phenomenon". N. Engl. J. Med. 347 (13): 1001–8. doi:10.1056/NEJMcp013013. PMID 12324557.