Mastoiditis physical examination: Difference between revisions

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==Overview==
==Overview==
Acute mastoiditis patients are usually ill-appearing and usually present with low-grade [[fever]]complicated mastoiditis patients may present with severely ill appearance. Mastoiditis physical examination findings include posterior auricular signs such as postauricular [[swelling]], [[erythema]], [[tenderness]], protrusion of [[pinna]], and sagging [[external ear]] canal. [[Otoscopy|Otoscopic]] examination findings include [[erythema]], bulging, cloud appearance, and immobility of the [[tympanic membrane]].
Acute mastoiditis patients are usually ill-appearing and usually present with low-grade [[fever]]. Patients with complicated mastoiditis may appear severly ill. Mastoiditis physical examination findings include posterior auricular signs such as postauricular [[swelling]], [[erythema]], [[tenderness]], protrusion of [[pinna]], and sagging [[external ear]] canal. [[Otoscopy|Otoscopic]] examination findings include [[erythema]], bulging, cloudy appearance, and immobility of the [[tympanic membrane]].


==Physical Examination==
==Physical Examination==
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=== Appearance of the Patient ===
=== Appearance of the Patient ===
Patients with mastoiditis usually appear ill and have marked [[inflammation]] and [[edema]] of the periuricular area.
Patients with mastoiditis usually appear ill and have marked [[inflammation]] and [[edema]] of the periauricular area.


=== Vital Signs ===
=== Vital Signs ===
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=== Skin ===
=== Skin ===
Patients with mastoiditis may present with the following skin findings:
Patients with mastoiditis may present with the following skin findings:
* [[Erythema]] of the periuricular skin
* [[Erythema]] of the periauricular skin
* [[Edema]] of the periuricular skin
* [[Edema]] of the periauricular skin
[[image:Mastoiditisphe.jpg|200px]]
[[image:Mastoiditisphe.jpg|200px]]


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==== Head ====
==== Head ====
Patients with mastoiditis may present with the following signs:
Patients with mastoiditis may present with the following signs:
* Evidence of recent [[Orbit (anatomy)|l]] [[trauma]]
* Evidence of recent [[Orbit (anatomy)|eye]] [[trauma]]
* Evidence of recent [[insect bites]]
* Evidence of recent [[insect bites]]


==== Ear ====
==== Ear ====
Patients with mastoiditis may present with below signs:
Patients with mastoiditis may present with the following signs:
* [[Otorrhea]]
* [[Otorrhea]]
* Postauricular [[swelling]]
* Postauricular [[swelling]]
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* Blurred [[tympanic membrane]]
* Blurred [[tympanic membrane]]


Mastoiditis patients may present with signs which are suggestive of [[Otitis interna|inner]] or [[Otitis media|middle ear infection]]:
Mastoiditis patients may present with signs that are suggestive of [[Otitis interna|inner]] or [[Otitis media|middle ear infection]]:
* [[Erythema]], [[edema]] and [[discharge]] present on [[otoscopy]]
* [[Erythema]], [[edema]], and [[discharge]] present on [[otoscopy]]
* [[Hearing loss]]
* [[Hearing loss]]
* Children may show signs of "tugging" on the affected ear
* Children may show signs of "tugging" on the affected ear
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{{WH}}
{{WH}}
{{WS}}
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[[Category:Emergency mdicine]]
[[Category:Disease]]
[[Category:Up-To-Date]]
[[Category:Infectious disease]]
[[Category:Otolaryngology]]
[[Category:Surgery]]

Latest revision as of 22:39, 29 July 2020

Mastoiditis Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Mastoiditis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

CT

MRI

Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

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

Overview

Acute mastoiditis patients are usually ill-appearing and usually present with low-grade fever. Patients with complicated mastoiditis may appear severly ill. Mastoiditis physical examination findings include posterior auricular signs such as postauricular swelling, erythema, tenderness, protrusion of pinna, and sagging external ear canal. Otoscopic examination findings include erythema, bulging, cloudy appearance, and immobility of the tympanic membrane.

Physical Examination

Patients with mastoiditis may present with some or all of the following signs:[1][2][3][4][5]

Appearance of the Patient

Patients with mastoiditis usually appear ill and have marked inflammation and edema of the periauricular area.

Vital Signs

Patients with mastoiditis may have the following vital signs, which are suggestive of infection:

Skin

Patients with mastoiditis may present with the following skin findings:

  • Erythema of the periauricular skin
  • Edema of the periauricular skin

HEENT

Patients with mastoiditis may have the following HEENT findings on physical examination:

Head

Patients with mastoiditis may present with the following signs:

Ear

Patients with mastoiditis may present with the following signs:

Mastoiditis patients may present with signs that are suggestive of inner or middle ear infection:

Throat/Oral

Patients with mastoiditis may present with signs which are suggestive of oral, pharyngeal, or upper respiratory tract infections:

Neck

Patients with mastoiditis may present with tender cervical lymph nodes, which are suggestive of regional infection.

References

  1. Zhang Y, Xu M, Zhang J, Zeng L, Wang Y, Zheng QY (2014). "Risk factors for chronic and recurrent otitis media-a meta-analysis". PLoS ONE. 9 (1): e86397. doi:10.1371/journal.pone.0086397. PMC 3900534. PMID 24466073.
  2. Holt GR, Gates GA (1983). "Masked mastoiditis". Laryngoscope. 93 (8): 1034–7. PMID 6877011.
  3. van den Aardweg MT, Rovers MM, de Ru JA, Albers FW, Schilder AG (2008). "A systematic review of diagnostic criteria for acute mastoiditis in children". Otol. Neurotol. 29 (6): 751–7. doi:10.1097/MAO.0b013e31817f736b. PMID 18617870.
  4. Lin HW, Shargorodsky J, Gopen Q (2010). "Clinical strategies for the management of acute mastoiditis in the pediatric population". Clin Pediatr (Phila). 49 (2): 110–5. doi:10.1177/0009922809344349. PMID 19734439.
  5. Pang LH, Barakate MS, Havas TE (2009). "Mastoiditis in a paediatric population: a review of 11 years experience in management". Int. J. Pediatr. Otorhinolaryngol. 73 (11): 1520–4. doi:10.1016/j.ijporl.2009.07.003. PMID 19758711.

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