Hypocalcemia physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vamsikrishna Gunnam M.B.B.S [2]

Overview

The clinical manifestations of hypocalcemia depend on the degree of hypocalcemia. Common physical examination findings of hypocalcemia include Chvostek's sign, Trousseau's sign, and circumoral numbness.

Physical Examination

Physical examination of patients with hypocalcemia shows the following

Appearance of the Patient

• Patients with hypocalcemia usually appear confused,disoriented,fatigue.

Skin

• Dry skin
• Coarse hair
• Brittle nails
• Alopecia
• Enamel hypoplasia
• Shortened premolar roots
• Thickened lamina dura
• Delayed tooth eruption
• Increased dental caries
• Atopic eczema
• Exfoliative dermatitis
• Psoriasis
• Impetigo herpetiformis

HEENT

• Subcapsular cataracts
• Papilledema

Neuromuscular

• Chvostek's sign: Elicited by tapping the skin over the facial nerve anterior to the external auditory meatus.
• Trousseau's sign: Elicited by inflation of a blood pressure cuff to 20 mm Hg above the patient's systolic blood pressure for 3-5 minutes.
• Paresthesias
• Tetany
• Seizures (focal, petit mal, grand mal)
• Muscle cramps
• Muscle weakness
• Laryngospasm
• Bronchospasm

Neurological signs 

• Extrapyramidal signs due to calcification of basal ganglia
• Calcification of cerebral cortex or cerebellum
• Personality disturbances
• Irritability
• Impaired intellectual ability
• Nonspecific EEG changes
• Increased intracranial pressure
• Parkinsonism
• Choreoathetosis
• Dystonic spasm
• Confusion
• Disorientation
• Psychosis
• Fatigue
• Anxiety
• Poor memory
• Reduced concentration
• Confusion
• Disorientation
• Psychosis
• Fatigue
• Anxiety
• Poor memory
• Reduced concentration

Abdomen

• Abdominal pain
• Biliary colic

Lungs

• Dyspnea
• Wheezing

Heart

• Prolonged QT interval on EKG
• Congestive heart failure
• Cardiomyopathy