Sickle-cell disease physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shyam Patel [2]
Overview
Nearly every body system and organ warrants physical examination in a patient with sickle cell disease since vaso-occlusive episodes can occur in many different vascular beds.
Physical examination
The physical examination of a patient with sickle cell disease includes head-to-toe evaluation for disease-specific complications. Vaso-occlusive crises can occur in nearly any vascular bed. The physical exam should thus be guided by symptoms at presentation. For example, a patient with sickle cell disease who presents with headache should receive neurological exam, which may given insight into the specific location of vaso-occlusive phenomenon. For example, central retinal artery occlusion can be seen in patients with sickle cell disease, so a detailed eye examination should be done in the appropriate clinical context.[1] A detailed cardiac and pulmonary exam should done for patients who present with shortness of breath, given that acute chest syndrome and pulmonary embolism are common manifestations of sickle-cell disease.[1] Exam of spleen size is important since autosplenctomy can occur. Patients with sickle cell disease are also at risk for infectious complications, given splenic dysfunction. Regarding infectious complications, attention should be paid to signs of pneumonia (e.g., egophony, decreased breath sounds), osteomyelitis (bone pain, etc), urinary tract infections (e.g. dysuria, increased frequency of urination), meningitis (e.g. headache, stiff neck, photophobia, and altered mental status), and other signs of sepsis (fever, tachycardia, tachypnea).[2]
References
- ↑ 1.0 1.1 Brandow AM, Liem R (2011). ""Sickle Cell Disease in the Emergency Department: Atypical Complications and Management"". Clin Pediatr Emerg Med. 12 (3): 202–212. doi:10.1016/j.cpem.2011.07.003. PMC 3172721. PMID 21927581.
- ↑ Zempsky WT (2010). "Evaluation and Treatment of Sickle Cell Pain in the Emergency Department: Paths to a Better Future". Clin Pediatr Emerg Med. 11 (4): 265–273. doi:10.1016/j.cpem.2010.09.002. PMC 3076949. PMID 21499553.