Ulcerative colitis physical examination: Difference between revisions
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== Physical Examination == | == Physical Examination == | ||
As ulcerative colitis is a [[systemic]] disease, patients may present with [[symptom]]s and [[complication (medicine)|complications]] outside the colon. These include the following:<ref name="pmid8596552">{{cite journal| author=Hanauer SB| title=Inflammatory bowel disease. | journal=N Engl J Med | year= 1996 | volume= 334 | issue= 13 | pages= 841-8 | pmid=8596552 | doi=10.1056/NEJM199603283341307 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8596552 }} </ref> | As ulcerative colitis is a [[systemic]] disease, patients may present with [[symptom]]s and [[complication (medicine)|complications]] outside the colon. These include the following:<ref name="pmid8596552">{{cite journal| author=Hanauer SB| title=Inflammatory bowel disease. | journal=N Engl J Med | year= 1996 | volume= 334 | issue= 13 | pages= 841-8 | pmid=8596552 | doi=10.1056/NEJM199603283341307 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8596552 }} </ref><ref name="pmid9260788">{{cite journal| author=D'Haens G, Geboes K, Peeters M, Baert F, Ectors N, Rutgeerts P| title=Patchy cecal inflammation associated with distal ulcerative colitis: a prospective endoscopic study. | journal=Am J Gastroenterol | year= 1997 | volume= 92 | issue= 8 | pages= 1275-9 | pmid=9260788 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9260788 }} </ref><ref name="pmid10566726">{{cite journal| author=Kim B, Barnett JL, Kleer CG, Appelman HD| title=Endoscopic and histological patchiness in treated ulcerative colitis. | journal=Am J Gastroenterol | year= 1999 | volume= 94 | issue= 11 | pages= 3258-62 | pmid=10566726 | doi=10.1111/j.1572-0241.1999.01533.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10566726 }} </ref> | ||
===General appearance=== | |||
===Vital signs=== | |||
===Gastrointestinal=== | |||
===Eyes=== | ===Eyes=== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Ulcerative colitis shows intestinal and extra intestinal findings on physical examination. These include abdominal tenderness, inflammation of the iris and uvea, skin rash, inflammation of the joints, aphthous ulcers and clubbing of the fingers.[1][2]
Physical Examination
As ulcerative colitis is a systemic disease, patients may present with symptoms and complications outside the colon. These include the following:[1][3][4]
General appearance
Vital signs
Gastrointestinal
Eyes
The ophthalmic physical exam findings may include:
Musculoskeletal
- Musculoskeletal:
- Seronegative arthritis, which can be a large-joint oligoarthritis (affecting one or two joints), or may affect many small joints of the hands and feet
- Ankylosing spondylitis, arthritis of the spine
- Sacroiliitis, arthritis of the lower spine
Skin
- Cutaneous (related to the skin):
- Erythema nodosum, which is a panniculitis, or inflammation of subcutaneous tissue involving the lower extremities
- Pyoderma gangrenosum, which is a painful ulcerating lesion involving the skin
Other
- Deep venous thrombosis and pulmonary embolism
- Autoimmune hemolytic anemia
- Clubbing, a deformity of the ends of the fingers
- Primary sclerosing cholangitis, or inflammation of the bile ducts
- Aphthous ulcers of the mouth
-
Patients with ulcerative colitis can occasionally have Aphthous ulcers involving the tongue, lips, palate and pharynx
References
- ↑ 1.0 1.1 Hanauer SB (1996). "Inflammatory bowel disease". N Engl J Med. 334 (13): 841–8. doi:10.1056/NEJM199603283341307. PMID 8596552.
- ↑ Prantera C, Davoli M, Lorenzetti R, Pallone F, Marcheggiano A, Iannoni C; et al. (1988). "Clinical and laboratory indicators of extent of ulcerative colitis. Serum C-reactive protein helps the most". J Clin Gastroenterol. 10 (1): 41–5. PMID 3356884.
- ↑ D'Haens G, Geboes K, Peeters M, Baert F, Ectors N, Rutgeerts P (1997). "Patchy cecal inflammation associated with distal ulcerative colitis: a prospective endoscopic study". Am J Gastroenterol. 92 (8): 1275–9. PMID 9260788.
- ↑ Kim B, Barnett JL, Kleer CG, Appelman HD (1999). "Endoscopic and histological patchiness in treated ulcerative colitis". Am J Gastroenterol. 94 (11): 3258–62. doi:10.1111/j.1572-0241.1999.01533.x. PMID 10566726.