Rhabdomyosarcoma physical examination: Difference between revisions

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__NOTOC__
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{{Rhabdomyosarcoma}}
{{Rhabdomyosarcoma}}
{{CMG}}; {AE}} {{S.M}}
{{CMG}}; {{AE}} {{S.M}}
==Overview==
==Overview==
[[Physical examination]] findings depend on the [[tumor]] [[origin]] and the presence or absence of [[metastases]]. [[Physical examination]] of [[patients]] with [[rhabdomyosarcoma]] is usually remarkable for nontender, [[palpable]] [[mass]], [[fever]], and erythmatous [[skin]] might be present.
==Physical Examination==
==Physical Examination==
* Physical examination findings depend on the tumor origin and the presence or absence of metastases.
* [[Physical examination]] findings depend on the [[tumor]] [[origin]] and the presence or absence of [[metastases]].<ref name="pmid3275486">{{cite journal| author=Maurer HM, Beltangady M, Gehan EA, Crist W, Hammond D, Hays DM et al.| title=The Intergroup Rhabdomyosarcoma Study-I. A final report. | journal=Cancer | year= 1988 | volume= 61 | issue= 2 | pages= 209-20 | pmid=3275486 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=3275486  }}</ref>
* Physical examination of patients with rhabdomyosarcoma is usually remarkable for nontender, palpable mass.
* [[Physical examination]] of [[patients]] with [[rhabdomyosarcoma]] is usually remarkable for nontender, [[palpable]] [[mass]].
===Appearance of the Patient===
===Appearance of the Patient===
*Patients with rhabdomyosarcoma usually have normal appearance.  
*[[Patients]] with [[rhabdomyosarcoma]] usually have [[normal]] [[appearance]].  


===Vital Signs===
===Vital Signs===


* Fever may be present
* [[Fever]] may be present.


===Skin===
===Skin===
* Skin examination of patients with Rhabdomyosarcoma may be erythmatous.
* [[Skin]] [[examination]] of [[patients]] with [[rhabdomyosarcoma]] may be erythmatous.


===HEENT===
===HEENT===
* HEENT examination of patients with rhabdomyosarcoma depends on tumor site.
* HEENT [[examination]] of [[patients]] with [[rhabdomyosarcoma]] depends on [[tumor]] site.
* Abnormal physical examination findings are:
* [[Abnormal]] [[physical examination]] findings are:<ref name="pmid23577029">{{cite journal| author=Rao AA, Naheedy JH, Chen JY, Robbins SL, Ramkumar HL| title=A clinical update and radiologic review of pediatric orbital and ocular tumors. | journal=J Oncol | year= 2013 | volume= 2013 | issue=  | pages= 975908 | pmid=23577029 | doi=10.1155/2013/975908 | pmc=3610355 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23577029  }}</ref>
** Proptosis
** [[Proptosis]]
** Ophtalmoplasia
** Ophtalmoplasia
** Dysconjugate gaze
** Dysconjugate gaze
** Presence of localized nontender enlarging mass
** Presence of localized nontender enlarging [[mass]]


===Neck===
===Neck===
* Neck examination of patients with rhabdomyosarcoma may be presence of nontender enlarging mass.
* [[Neck]] [[examination]] of [[patients]] with [[rhabdomyosarcoma]] may be presence of nontender enlarging [[mass]].


===Lungs===
===Lungs===
* Pulmonary examination of patients with metastatic rhabdomyosarcoma may be infavor of pleural effusion.  
* [[Pulmonary]] [[examination]] of [[patients]] with [[metastatic]] [[rhabdomyosarcoma]] may be in favor of [[pleural effusion]].  


===Heart===
===Heart===
* Cardiovascular examination of patients with rhabdomyosarcoma is usually normal.
* [[Cardiovascular]] [[examination]] of [[patients]] with [[rhabdomyosarcoma]] is usually [[normal]].


===Abdomen===
===Abdomen===
* Abdominal examination of patients with  is usually normal.
* [[Abdominal]] [[examination]] of [[patients]] with is usually [[normal]].
OR
*[[Abdominal distension]]  
*[[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===
* Back examination of patients with [disease name] is usually normal.
* [[Back]] [[examination]] of [[patients]] with [[rhabdomyosarcoma]] is usually [[normal]].
OR
*Point tenderness over __ vertebrae (e.g. L3-L4)
*Sacral edema
*Costovertebral angle tenderness bilaterally/unilaterally
*Buffalo hump


===Genitourinary===
===Genitourinary===
* Genitourinary examination of patients with [disease name] is usually normal.
* [[Genitourinary]] [[examination]] of [[patients]] with [[rhabdomyosarcoma]] depends on [[tumor]] site.
OR
** [[Vaginal]] [[tumors]] may have [[Polyploidy|polypoid]] [[mass]] protrusion and/ or mucosanguineous [[discharge]].
*A pelvic/adnexal mass may be palpated
** Paratesticular [[tumors]] may have nontender [[Scrotal mass|scrotal]] or [[inguinal]] [[mass]].
*Inflamed mucosa
*Clear/(color), foul-smelling/odorless penile/vaginal discharge
 
===Neuromuscular===
===Neuromuscular===
* Neuromuscular examination of patients with [disease name] is usually normal.
* [[Neuromuscular]] [[examination]] of [[patients]] with [[rhabdomyosarcoma]] 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)


===Extremities===
===Extremities===
* Extremities examination of patients with [disease name] is usually normal.
* [[Extremities]] [[examination]] of [[patients]] with [[rhabdomyosarcoma]] may have [[Tenderness|tender]] or nontender [[mass]].
OR
*[[Clubbing]]  
*[[Cyanosis]]  
*Pitting/non-pitting [[edema]] of the upper/lower extremities
*Muscle atrophy
*Fasciculations in the upper/lower extremity
 
 


==References==
==References==
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Latest revision as of 13:23, 2 April 2019

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

Overview

Physical examination findings depend on the tumor origin and the presence or absence of metastases. Physical examination of patients with rhabdomyosarcoma is usually remarkable for nontender, palpable mass, fever, and erythmatous skin might be present.

Physical Examination

Appearance of the Patient

Vital Signs

Skin

HEENT

Neck

Lungs

Heart

Abdomen

Back

Genitourinary

Neuromuscular

Extremities

References

  1. Maurer HM, Beltangady M, Gehan EA, Crist W, Hammond D, Hays DM; et al. (1988). "The Intergroup Rhabdomyosarcoma Study-I. A final report". Cancer. 61 (2): 209–20. PMID 3275486.
  2. Rao AA, Naheedy JH, Chen JY, Robbins SL, Ramkumar HL (2013). "A clinical update and radiologic review of pediatric orbital and ocular tumors". J Oncol. 2013: 975908. doi:10.1155/2013/975908. PMC 3610355. PMID 23577029.

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