Caplans syndrome physical examination

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

Common physical examination findings of Caplan Syndrome include typical Rheumatoid arthritis features as swollen, tender metacarpophalangeal and proximal interphalangeal joints. Pulmonary findings might include wheeze, crackles not improving with coughing.

Physical Examination

Most of the patients with Caplan Syndrome are asymptomatic. But following can be found on physical examination.

. Rheumatoid nodules.

. Swollen, tender metacarpophalangeal joints and interphalangeal joints.

. Wheeze and crackles in chest.

Appearance of the Patient

• Patients with Caplan Syndrome usually appear normal.

Vital Signs

Vital signs in patients with Caplan Syndrome are usually normal.

Skin

• Skin examination of patients with Caplan Syndrome is usually normal.

HEENT

• HEENT examination of patients with Caplan Syndrome is usually normal.

Neck

• Neck examination of patients with Caplan Syndrome is usually normal.

Lungs

• Auscultation may reveal diffuse râles that do not disappear on coughing or taking a deep breath.

Extremities

• Tender, swollen MCP joints and rheumatoid nodules

Heart

• Cardiovascular examination of patients with Caplan Syndrome is usually normal.

Abdomen

• Abdominal examination of patients with [disease name] 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 examination of patients with [disease name] is usually normal.

OR

• Point tenderness over __ vertebrae (e.g. L3-L4)
• Sacral edema
• Costovertebral angle tenderness bilaterally/unilaterally
• Buffalo hump

Genitourinary

• Genitourinary examination of patients with [disease name] is usually normal.

OR

• A pelvic/adnexal mass may be palpated
• Inflamed mucosa
• Clear/(color), foul-smelling/odorless penile/vaginal discharge

Neuromuscular

• Neuromuscular examination of patients with [disease name] 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 examination of patients with [disease name] is usually normal.

OR

• Clubbing
• Cyanosis
• Pitting/non-pitting edema of the upper/lower extremities
• Muscle atrophy
• Fasciculations in the upper/lower extremity