Polyarteritis nodosa physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Haritha Machavarapu, M.B.B.S.
Overview
Physical Examination

Physical examination plays an important role in diagnosing PAN.
Arteritis can be suspected with the presence of multiple mononeuropathies.
Signs of ischemia such as extremity ischemia, hypertension and renovascular disease can help in diagnosing PAN.

PAN may present with ophthalmologic symptoms like:
- Retinal vasculitis
- Retinal detachment
- Cotton-wool spots

Abdominal examination of patients with PAN shows:^[2]
- Abdominal tenderness
- Gastro-intestinal bleeding

Genitourinary examination of patients with PAN reveals testicular tenderness on palpation.

Neuromuscular examination of patients with PAN shows:^[3]
- Sensory and/or motor neuropathies
- Mononeuritis multiplex^[4]
  - Asymmetrical
  - Nerves that are usually involved include: ulnar, radial,peroneal etc.

References

↑ Stone JH (October 2002). "Polyarteritis nodosa". JAMA. 288 (13): 1632–9. PMID 12350194.
↑ Levine SM, Hellmann DB, Stone JH (April 2002). "Gastrointestinal involvement in polyarteritis nodosa (1986-2000): presentation and outcomes in 24 patients". Am. J. Med. 112 (5): 386–91. PMID 11904113.
↑ Rosenberg MR, Parshley M, Gibson S, Wernick R (November 1990). "Central nervous system polyarteritis nodosa". West. J. Med. 153 (5): 553–6. PMC 1002622. PMID 1979706.
↑ Griffin JW (November 2001). "Vasculitic neuropathies". Rheum. Dis. Clin. North Am. 27 (4): 751–60, vi. PMID 11723762.