Behçet's disease physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Hamid Qazi, MD, BSc [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 [disease name] is usually normal.

OR

Physical examination of patients with [disease name] 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

High-grade / low-grade fever
Hypothermia / hyperthermia may be present
Tachycardia with regular pulse or (ir)regularly irregular pulse
Bradycardia with regular pulse or (ir)regularly irregular pulse
Tachypnea / bradypnea
Kussmal respirations may be present in _____ (advanced disease state)
Weak/bounding pulse / pulsus alternans / paradoxical pulse / asymmetric pulse
High/low blood pressure with normal pulse pressure / wide pulse pressure / narrow pulse pressure

Skin

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

OR

Description (Adapted from Dermatology Atlas)

Description (Adapted from Dermatology Atlas)
Description (Adapted from Dermatology Atlas)

HEENT

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

OR

Abnormalities of the head/hair may include ___
Evidence of trauma
Icteric sclera
Nystagmus
Extra-ocular movements may be abnormal
Pupils non-reactive to light / non-reactive to accommodation / non-reactive to neither light nor accommodation
Ophthalmoscopic exam may be abnormal with findings of ___
Hearing acuity may be reduced
Weber test may be abnormal (Note: A positive Weber test is considered a normal finding / A negative Weber test is considered an abnormal finding. To avoid confusion, you may write "abnormal Weber test".)
Rinne test may be positive (Note: A positive Rinne test is considered a normal finding / A negative Rinne test is considered an abnormal finding. To avoid confusion, you may write "abnormal Rinne test".)
Exudate from the ear canal
Tenderness upon palpation of the ear pinnae/tragus (anterior to ear canal)
Inflamed nares / congested nares
Purulent exudate from the nares
Facial tenderness
Erythematous throat with/without tonsillar swelling, exudates, and/or petechiae

Neck

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

OR

Jugular venous distension
Carotid bruits may be auscultated unilaterally/bilaterally using the bell/diaphragm of the otoscope
Lymphadenopathy (describe location, size, tenderness, mobility, and symmetry)
Thyromegaly / thyroid nodules
Hepatojugular reflux

Lungs

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

OR

Asymmetric chest expansion / Decreased chest expansion
Lungs are hypo/hyperresonant
Fine/coarse crackles upon auscultation of the lung bases/apices unilaterally/bilaterally
Rhonchi
Vesicular breath sounds / Distant breath sounds
Expiratory/inspiratory wheezing with normal / delayed expiratory phase
Wheezing may be present
Egophony present/absent
Bronchophony present/absent
Normal/reduced tactile fremitus

Heart

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

OR

Chest tenderness upon palpation
PMI within 2 cm of the sternum (PMI) / Displaced point of maximal impulse (PMI) suggestive of ____
Heave / thrill
Friction rub
S1
S2
S3
S4
Gallops
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 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 [disease name] is usually normal.

OR

Point tenderness over __ vertebrae (e.g. L3-L4)
Sacral edema
Costovertebral angle tenderness bilaterally/unilaterally
Buffalo hump

Genitourinary

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

OR

A pelvic/adnexal mass may be palpated
Inflamed mucosa
Clear/(color), foul-smelling/odorless penile/vaginal discharge

Neuromuscular

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

OR

Patient is usually oriented to persons, place, and time
Altered mental status
Glasgow coma scale is ___ / 15
Clonus may be present
Hyperreflexia / hyporeflexia / areflexia
Positive (abnormal) Babinski / plantar reflex unilaterally/bilaterally
Muscle rigidity
Proximal/distal muscle weakness unilaterally/bilaterally
____ (finding) suggestive of cranial nerve ___ (roman numerical) deficit (e.g. Dilated pupils suggestive of CN III deficit)
Unilateral/bilateral upper/lower extremity weakness
Unilateral/bilateral sensory loss in the upper/lower extremity
Positive straight leg raise test
Abnormal gait (describe gait: e.g. ataxic (cerebellar) gait / steppage gait / waddling gait / choeiform gait / Parkinsonian gait / sensory gait)
Positive/negative Trendelenburg sign
Unilateral/bilateral tremor (describe tremor, e.g. at rest, pill-rolling)
Normal finger-to-nose test / Dysmetria
Absent/present dysdiadochokinesia (palm tapping test)