Sjögren's syndrome physical examination: Difference between revisions

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*Partial or complete loss of [[sweating]]
*Partial or complete loss of [[sweating]]
*Dry, sparse, and brittle hair may be present
*Dry, sparse, and brittle hair may be present
*Diffuse [[alopecia]] may involve the scalp, limbs, [[axillae]], or [[pubis]]
*Diffuse [[alopecia]] may involve the scalp, limbs, axilla, or [[pubis]]
*Nail folds may show capillaroscopic abnormalities
*Nail folds may show capillaroscopic abnormalities
*Nonpalpable or palpable, vasculitic purpura, with lesions that are typically 2-3 mm in diameter and located on the lower extremities may be present
*Nonpalpable or palpable, vasculitic purpura, with lesions that are typically 2-3 mm in diameter and located on the lower extremities may be present
Line 62: Line 62:
*Glasgow coma scale is 15/15
*Glasgow coma scale is 15/15
*[[Paraparesis]] maybe present  
*[[Paraparesis]] maybe present  
*Paraplegia may be present
*[[Paraplegia]] may be present


===Extremities===
===Extremities===

Revision as of 20:54, 19 April 2018

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

Overview

Physical examination of patients with is usually remarkable for dryness of all mucous membranes such as mouth, eyes, lips, anal and rectal.

Physical Examination

  • Physical examination of patients with is usually remarkable for dryness of all mucous membranes such as mouth, eyes, lips, anal and rectal.

Appearance of the Patient

Vital Signs

  • Vital sign might be normal.

Skin

  • Dryness of the skin
  • Scaling
  • Partial or complete loss of sweating
  • Dry, sparse, and brittle hair may be present
  • Diffuse alopecia may involve the scalp, limbs, axilla, or pubis
  • Nail folds may show capillaroscopic abnormalities
  • Nonpalpable or palpable, vasculitic purpura, with lesions that are typically 2-3 mm in diameter and located on the lower extremities may be present
  • Annular erythema with scales, localized especially on the face and neck

HEENT

  • Mucous dryness
  • Red, smooth, and dry tongue
  • Hyperlobulated tongue with loss of filiform papillae, and absence of salivary pooling under the tongue
  • Dental caries
  • Gingival inflammation
  • Parotid duct narrowing
  • Red, dry, and scaly lips
  • Cracks at the corners of the mouth
  • Chronic oral candidiasis
  • Atrophic changes in the mucous membranes of the upper respiratory tract

Neck

  • Bilateral parotid gland enlargement

Lungs

Heart

  • Cardiovascular examination of patients with Sjögren's syndrome is usually normal.

Abdomen

  • Splenomegaly

Back

  • Back examination of patients with Sjögren's syndrome is usually normal.

Genitourinary

Neuromuscular

  • Patient is usually oriented to persons, place, and time.
  • Glasgow coma scale is 15/15
  • Paraparesis maybe present
  • Paraplegia may be present

Extremities

References

  1. Lopate G, Pestronk A, Al-Lozi M, Lynch T, Florence J, Miller T, Levine T, Rampy T, Beson B, Ramneantu I (May 2006). "Peripheral neuropathy in an outpatient cohort of patients with Sjögren's syndrome". Muscle Nerve. 33 (5): 672–6. doi:10.1002/mus.20514. PMID 16453296.
  2. Antoniazzi RP, Miranda LA, Zanatta FB, Islabão AG, Gustafsson A, Chiapinotto GA, Oppermann RV (March 2009). "Periodontal conditions of individuals with Sjögren's syndrome". J. Periodontol. 80 (3): 429–35. doi:10.1902/jop.2009.080350. PMID 19254127.
  3. Riccieri V, Sciarra I, Ceccarelli F, Alessandri C, Croia C, Vasile M, Modesti MG, Priori R, Valesini G (June 2009). "Nailfold capillaroscopy abnormalities are associated with the presence of anti-endothelial cell antibodies in Sjogren's syndrome". Rheumatology (Oxford). 48 (6): 704–6. doi:10.1093/rheumatology/kep051. PMID 19307256.
  4. Ren H, Wang WM, Chen XN, Zhang W, Pan XX, Wang XL, Lin Y, Zhang S, Chen N (February 2008). "Renal involvement and followup of 130 patients with primary Sjögren's syndrome". J. Rheumatol. 35 (2): 278–84. PMID 18085734.
  5. Versura P, Frigato M, Cellini M, Mulè R, Malavolta N, Campos EC (February 2007). "Diagnostic performance of tear function tests in Sjogren's syndrome patients". Eye (Lond). 21 (2): 229–37. doi:10.1038/sj.eye.6702204. PMID 16397619.
  6. Lemp MA (September 2008). "Advances in understanding and managing dry eye disease". Am. J. Ophthalmol. 146 (3): 350–356. doi:10.1016/j.ajo.2008.05.016. PMID 18599017.

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