Osteoporosis physical examination: Difference between revisions

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{{Osteoporosis}}
{{Osteoporosis}}
{{CMG}} {{AE}} {{RT}}
{{CMG}} {{AE}}{{RT}}


==Overview==
==Overview==
[[Osteoporosis]] is associated with the presence of fractures on physical examination. Otherwise, there are no characteristic findings on physical examination.
[[Osteoporosis]] is generally [[asymptomatic]] during initial years; until the [[bone mass]] loss rich to the point that [[fractures]] occur. These [[fractures]] could be divided to acute and chronic ones; mostly involve [[femoral neck]] and [[Vertebral|vertebral bones]], respectively. The main feature of [[femoral]] [[fracture]] is immobilization and the main feature of [[vertebral]] [[fracture]] is Dowager's hump appearance. Any other secondary causes of the disease (e.g., chronic [[corticosteroid]] use or [[hyperthyroidism]]) may have their own symptoms; signifying a risk factor for [[osteoporosis]].


==Appearance of the Patient==
==Physical examination==
[[Osteoporosis]] is asymptomatic, until fractures occur due to poor bone mineralization. Such patients may appear anxious and distressed because of pain. Based on risk factors, the patient may likely be elderly, female, thin, of small stature, and asian or caucasian.  If they have osteoporosis due to chronic [[steroid]] use, they may also exhibit the physical characteristics that appear due to chronic steroid use. They may exhibit physical characteristics of other secondary causes of osteoporosis, such as [[hyperthyroidism]].
[[Osteoporosis]] is generally [[asymptomatic]] during initial years; until the [[bone mass]] loss rich to the point that [[fractures]] occur. These [[fractures]] could be divided to acute and chronic ones; mostly involve [[femoral neck]] and [[Vertebral|vertebral bones]], respectively. The main feature of [[femoral]] [[fracture]] is immobilization and the main feature of [[vertebral]] [[fracture]] is Dowager's hump appearance.  


==Vital Signs==
=== Appearance ===
===Temperature===
* In case of acute [[fractures]], patients may appear [[anxious]] and distressed because of pain. Based on risk factors, the patient may likely be elderly, female, thin, of short stature, and Asian or Caucasian.
*Temperature is normal.
* If they have [[osteoporosis]] due to chronic [[steroid|corticosteroid]] use, they may also exhibit the physical characteristics of chronic [[corticosteroid]] use; such as [[Buffalo hump]], [[Striae|abdominal striae]], moon-like faces, and edematous [[eyelids]].
* They may exhibit physical characteristics of other secondary causes of [[osteoporosis]], such as [[hyperthyroidism]] (include [[proptosis]], [[tremor]], and [[restlessness]]).


===Pulse===
===Vital Signs===
====Rate====
====Temperature====
*Normal
*Normal without fever
====Rhythm====
*Regular
====Strength====
*The pulse is normal
====Symmetry====
*The pulses are symmetric
===Blood Pressure===
*Normal
*[[Blood pressure]] may be elevated in chronic steroid use or hyperthyroidism, both of which are risk factors for osteoporosis
 
===Respiratory Rate===
*Normal
 
==Skin==
*Normal
*Striae may be present if there is chronic [[corticosteroid]] use, and signifying a risk factor for osteoporosis


==Head==
==== Blood pressure ====
* Normal
* Normal
* Characteristic round "puffy" face may be present with chronic steroid use, signifying a risk factor for osteoporosis


==Eyes==
====Pulse rate====
*Normal. No [[icterus]].
* Normal rate, [[rhythm]], and strength


==Ears==
====Respiratory rate====
*Normal
*Normal
==Nose==
===Skin===
*Normal
*Normal
==Throat==
*[[Striae]] may be present, if there is chronic [[corticosteroid]] use; signifying a risk factor for [[osteoporosis]]
*Normal
 
==Neck==
===Head===
*[[Jugular venous pressure]] not elevated
* Normal
*[[Carotid bruits]] not present
* Characteristic moon-like face (i.e., round "puffy" face) may be present with chronic [[corticosteroid]] use; signifying a risk factor for [[osteoporosis]]
*[[Lymph nodes]] not present
===Neck===
*[[Thyromegaly]] may be present in [[hyperthyroidism]]
*[[Thyromegaly]] may be present in [[hyperthyroidism]]
*[[Hepatojugular reflux]] is absent
* Large fat pad at the back of neck may be present due to chronic steroid use, which is a risk factor for osteoporosis
==Heart==
*Normal
==Lungs==
*Normal. No added sounds


===Auscultation===
===Abdomen===
*[[Heart sounds#First heart tone S1, the "lub"(components M1 and T1)|S1]] present
*[[Hepatomegaly]] usually absent
*[[Heart sounds#Second heart tone S2 the "dub"(components A2 and P2)|S2]] present
**[[Hepatomegaly]] may be found due to [[hemochromatosis]] or [[alcoholism]]; both signifying risk factors for [[osteoporosis]]
*Central [[obesity]] and [[striae]] may be seen in chronic [[corticosteroid]] use; signifying a risk factor for [[osteoporosis]]


==Abdomen==
=== Back ===
*[[Abdominal distention]] absent
* Point [[tenderness]] may be seen in case of [[fractures]]
*[[Abdominal tenderness]] absent
* Stooped back, "Dowager's hump"; caused by compression of [[vertebrae]]
*[[Rebound]] absent
* [[Kyphoscoliosis]] may be seen
*[[Hepatomegaly]] usually absent, liver may be palpable in liver disease due to [[hemochromatosis]] or [[alcoholism]], both of which are risk factors for osteoporosis.
* Shortened [[spinal column]]; caused by compression of [[vertebrae]]
*[[Splenomegaly]] absent
* [[Buffalo hump]] (Large fat pad at the back of neck) may be present due to chronic [[corticosteroid]] use; signifying a risk factor for [[osteoporosis]]
* Central [[obesity]] and striae may be seen in chronic steroid use, a risk factor for osteoporosis
* [[Hypogonadism]] may be evident on genitourinary exam, and is a risk factor for osteoporosis


==Extremities==
=== Genitourinary ===
*[[Clubbing]] absent
* [[Hypogonadism]] may be evident; signifying a risk factor for [[osteoporosis]]
*[[Cyanosis]] absent
*[[Edema]] absent
*[[Fracture]] or previously healed fractures may be present
*Peripheral muscle atrophy may be present with chronic steroid use, a risk factor for osteoporosis
*The patient may have experienced a decrease in height due to [[vertebral compression fractures]].


==Neurologic==
===Extremities===
*Normal examination
*[[Fracture]] or previously healed [[fractures]] may be present
*Peripheral [[Muscle-plate|muscle]] [[atrophy]] may be present with chronic [[corticosteroid]] use; signifying a risk factor for [[osteoporosis]]


==References==
==References==

Revision as of 16:11, 4 August 2017

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

Overview

Osteoporosis is generally asymptomatic during initial years; until the bone mass loss rich to the point that fractures occur. These fractures could be divided to acute and chronic ones; mostly involve femoral neck and vertebral bones, respectively. The main feature of femoral fracture is immobilization and the main feature of vertebral fracture is Dowager's hump appearance. Any other secondary causes of the disease (e.g., chronic corticosteroid use or hyperthyroidism) may have their own symptoms; signifying a risk factor for osteoporosis.

Physical examination

Osteoporosis is generally asymptomatic during initial years; until the bone mass loss rich to the point that fractures occur. These fractures could be divided to acute and chronic ones; mostly involve femoral neck and vertebral bones, respectively. The main feature of femoral fracture is immobilization and the main feature of vertebral fracture is Dowager's hump appearance.

Appearance

Vital Signs

Temperature

  • Normal without fever

Blood pressure

  • Normal

Pulse rate

  • Normal rate, rhythm, and strength

Respiratory rate

  • Normal

Skin

Head

  • Normal
  • Characteristic moon-like face (i.e., round "puffy" face) may be present with chronic corticosteroid use; signifying a risk factor for osteoporosis

Neck

Abdomen

Back

Genitourinary

Extremities

References

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