Adrenal insufficiency physical examination
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Patients with [disease name] usually appear [general appearance]. Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
OR
Common physical examination findings of [disease name] include [finding 1], [finding 2], and [finding 3].
OR
The presence of [finding(s)] on physical examination is diagnostic of [disease name].
OR
The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
Physical Examination
Physical examination of patients with [disease name] is usually normal.
OR
Physical examination of patients with [disease name] is usually remarkable for [finding 1], [finding 2], and [finding 3].
OR
The presence of [finding(s)] on physical examination is diagnostic of [disease name].
OR
The presence of [finding(s)] on physical examination is highly suggestive of [disease name].
Appearance of the Patient
- Patients with [disease name] usually appear [general appearance].
Vital Signs
- Fever maybe present in adrenal insufficiency. [1]
- Low blood pressure with normal pulse pressure is seen, especially in [[primary adrenal insufficiency due to mineralocorticoid deficiency.
- Adrenal crisis presents with hypotension, tachycardia, hypovolemia. [2]
Skin
- Skin examination of patients with primary adrenal insufficiency includes: [3]
- Hyperpigmentation, commonly affecting the palmar creases, perineum, axilla, and areola. It is most prominent in areas exposed to trauma, pressure and sun.
- Mucosal hyperpigmentation commonly effects buccal, gingival, tongue, vermillion border of lips. [4]
- Loss of axillary and pubic hair in women with primary adrenal insufficiency
- Horizontal bands of hyperpigmentation on the nails.
HEENT
- HEENT examination of patients with adrenal insufficiency is usually normal.
Neck
- Neck examination of patients with adrenal insufficiency is usually normal.
Lungs
- Pulmonary examination of patients with adrenal insufficiency is usually normal.
Heart
- Cardiovascular examination of patients with adrenal insufficiency is usually normal.
Abdomen
- Abdominal tenderness and guarding can be present in adrenal crisis [5]
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
References
- ↑ "StatPearls". 2020. PMID 28722862.
- ↑ Pazderska, Agnieszka; Pearce, Simon HS (2017). "Adrenal insufficiency – recognition and management". Clinical Medicine. 17 (3): 258–262. doi:10.7861/clinmedicine.17-3-258. ISSN 1470-2118.
- ↑ Lause M, Kamboj A, Fernandez Faith E (2017). "Dermatologic manifestations of endocrine disorders". Transl Pediatr. 6 (4): 300–312. doi:10.21037/tp.2017.09.08. PMC 5682371. PMID 29184811.
- ↑ Sarkar, SoumyaBrata; Sarkar, Subrata; Ghosh, Supratim; Bandyopadhyay, Subhankar (2012). "Addison′s disease". Contemporary Clinical Dentistry. 3 (4): 484. doi:10.4103/0976-237X.107450. ISSN 0976-237X.
- ↑ https://www.amjmed.com/article/S0002-9343(15)00827-X/pdf