Splenomegaly physical examination: Difference between revisions
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==Physical Examination== | ==Physical Examination== | ||
===Abdomen=== | . ===Abdomen=== | ||
In young patients, splenomegaly can be assessed by turning the patient on the right side in order to have the | In young patients, splenomegaly can be assessed by turning the patient on the right side in order to have the | ||
spleen falling downwards. In this position, the spleen should not be palpable under normal conditions. A palpable | spleen falling downwards. In this position, the spleen should not be palpable under normal conditions. Start from below to look for splenomegaly. Rule out a palpable kidney by allotment by bimanual palpation. A palpable | ||
spleen indicates that its size is increased by at least two-fold. In adolescent and adult patients, mild splenomegaly may only be detected by abdominal imaging such as ultrasound.<ref name="Patterson-2012">{{Cite journal | last1 = Patterson | first1 = MC. | last2 = Hendriksz | first2 = CJ. | last3 = Walterfang | first3 = M. | last4 = Sedel | first4 = F. | last5 = Vanier | first5 = MT. | last6 = Wijburg | first6 = F. | last7 = Baumgartner | first7 = M. | last8 = Bembi | first8 = B. | last9 = Bonnot | first9 = C. | title = Recommendations for the diagnosis and management of Niemann-Pick disease type C: an update. | journal = Mol Genet Metab | volume = 106 | issue = 3 | pages = 330-44 | month = Jul | year = 2012 | doi = 10.1016/j.ymgme.2012.03.012 | PMID = 22572546 }}</ref> | spleen indicates that its size is increased by at least two-fold. Spleen is said to be moderately enlarged when it is more than 2-4 finger breath or 4-8cm from the costal margin. In adolescent and adult patients, mild splenomegaly may only be detected by abdominal imaging such as ultrasound.<ref name="Patterson-2012">{{Cite journal | last1 = Patterson | first1 = MC. | last2 = Hendriksz | first2 = CJ. | last3 = Walterfang | first3 = M. | last4 = Sedel | first4 = F. | last5 = Vanier | first5 = MT. | last6 = Wijburg | first6 = F. | last7 = Baumgartner | first7 = M. | last8 = Bembi | first8 = B. | last9 = Bonnot | first9 = C. | title = Recommendations for the diagnosis and management of Niemann-Pick disease type C: an update. | journal = Mol Genet Metab | volume = 106 | issue = 3 | pages = 330-44 | month = Jul | year = 2012 | doi = 10.1016/j.ymgme.2012.03.012 | PMID = 22572546 }}</ref> | ||
* Palpable left upper quadrant [[abdominal mass]] | * Palpable left upper quadrant [[abdominal mass]], feel for spelling notch | ||
* Splenic rub | * Auscultate for Splenic rub | ||
* [[Castell's sign]]<ref name="pmid8411607">{{cite journal |author=Grover SA, Barkun AN, Sackett DL |title=The rational clinical examination. Does this patient have splenomegaly? |journal=JAMA |volume=270 |issue=18 |pages=2218-21 |year=1993 |pmid=8411607 |doi=}} [http://gateway.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=8411607.ui Ovid full text]</ref> | * [[Castell's sign]]<ref name="pmid8411607">{{cite journal |author=Grover SA, Barkun AN, Sackett DL |title=The rational clinical examination. Does this patient have splenomegaly? |journal=JAMA |volume=270 |issue=18 |pages=2218-21 |year=1993 |pmid=8411607 |doi=}} [http://gateway.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=8411607.ui Ovid full text]</ref> | ||
Revision as of 16:10, 7 January 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Physical Examination
. ===Abdomen=== In young patients, splenomegaly can be assessed by turning the patient on the right side in order to have the spleen falling downwards. In this position, the spleen should not be palpable under normal conditions. Start from below to look for splenomegaly. Rule out a palpable kidney by allotment by bimanual palpation. A palpable spleen indicates that its size is increased by at least two-fold. Spleen is said to be moderately enlarged when it is more than 2-4 finger breath or 4-8cm from the costal margin. In adolescent and adult patients, mild splenomegaly may only be detected by abdominal imaging such as ultrasound.[1]
- Palpable left upper quadrant abdominal mass, feel for spelling notch
- Auscultate for Splenic rub
- Castell's sign[2]
References
- ↑ Patterson, MC.; Hendriksz, CJ.; Walterfang, M.; Sedel, F.; Vanier, MT.; Wijburg, F.; Baumgartner, M.; Bembi, B.; Bonnot, C. (2012). "Recommendations for the diagnosis and management of Niemann-Pick disease type C: an update". Mol Genet Metab. 106 (3): 330–44. doi:10.1016/j.ymgme.2012.03.012. PMID 22572546. Unknown parameter
|month=ignored (help) - ↑ Grover SA, Barkun AN, Sackett DL (1993). "The rational clinical examination. Does this patient have splenomegaly?". JAMA. 270 (18): 2218–21. PMID 8411607. Ovid full text