Hypocalcemia physical examination

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

Overview

The clinical manifestations of hypocalcemia depend on the degree of hypocalcemia. Common physical examination findings of hypocalcemia include Chvostek’s sign, Trousseau’s sign, and circumoral numbness.

Physical Examination

Physical examination of patients with hypocalcemia shows the following

Appearance of the Patient

Patients with hypocalcemia usually appear confused,disoriented,fatigue.

Skin

Dry skin
Coarse hair
Brittle nails
Alopecia
Enamel hypoplasia
Shortened premolar roots
Thickened lamina dura
Delayed tooth eruption
Increased dental caries
Atopic eczema
Exfoliative dermatitis
Psoriasis
Impetigo herpetiformis

HEENT

Subcapsular cataracts
Papilledema

Neuromuscular

Chvostek’s sign: Elicited by tapping the skin over the facial nerve anterior to the external auditory meatus.^[1]^[2]
Trousseau’s sign: Elicited by inflation of a blood pressure cuff to 20 mm Hg above the patient’s systolic blood pressure for 3-5 minutes.^[3]^[4]
Paresthesias
Tetany
Seizures (focal, petit mal, grand mal)
Muscle cramps
Muscle weakness
Laryngospasm
Bronchospasm

Neurological signs

Extrapyramidal signs due to calcification of basal ganglia
Calcification of cerebral cortex or cerebellum
Personality disturbances
Irritability
Impaired intellectual ability
Nonspecific EEG changes
Increased intracranial pressure
Parkinsonism
Choreoathetosis
Dystonic spasm
Confusion
Disorientation
Psychosis
Fatigue
Anxiety
Poor memory
Reduced concentration
Confusion
Disorientation
Psychosis
Fatigue
Anxiety
Poor memory
Reduced concentration

Abdomen

Lungs

Heart

References

↑ Jesus, John Edwin; Landry, Alden (2012). “Chvostek’s and Trousseau’s Signs”. New England Journal of Medicine. 367 (11): e15. doi:10.1056/NEJMicm1110569. ISSN 0028-4793.
↑ Mohebbi MR, Rosenkrans KA, Jung MJ (May 2013). “Chvostek’s and Trousseau’s signs in a Case of Hypoparathyroidism”. J Clin Diagn Res. 7 (5): 970. doi:10.7860/JCDR/2013/5592.2992. PMC 3681085. PMID 23814758.
↑ Jesus, John Edwin; Landry, Alden (2012). “Chvostek’s and Trousseau’s Signs”. New England Journal of Medicine. 367 (11): e15. doi:10.1056/NEJMicm1110569. ISSN 0028-4793.
↑ Mohebbi MR, Rosenkrans KA, Jung MJ (May 2013). “Chvostek’s and Trousseau’s signs in a Case of Hypoparathyroidism”. J Clin Diagn Res. 7 (5): 970. doi:10.7860/JCDR/2013/5592.2992. PMC 3681085. PMID 23814758.

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[JesusLandry2012-1] Jesus, John Edwin; Landry, Alden (2012). “Chvostek’s and Trousseau’s Signs”. New England Journal of Medicine. 367 (11): e15. doi:10.1056/NEJMicm1110569. ISSN 0028-4793.

[pmid23814758-2] Mohebbi MR, Rosenkrans KA, Jung MJ (May 2013). “Chvostek’s and Trousseau’s signs in a Case of Hypoparathyroidism”. J Clin Diagn Res. 7 (5): 970. doi:10.7860/JCDR/2013/5592.2992. PMC 3681085. PMID 23814758.

[JesusLandry20122-3] Jesus, John Edwin; Landry, Alden (2012). “Chvostek’s and Trousseau’s Signs”. New England Journal of Medicine. 367 (11): e15. doi:10.1056/NEJMicm1110569. ISSN 0028-4793.

[pmid238147582-4] Mohebbi MR, Rosenkrans KA, Jung MJ (May 2013). “Chvostek’s and Trousseau’s signs in a Case of Hypoparathyroidism”. J Clin Diagn Res. 7 (5): 970. doi:10.7860/JCDR/2013/5592.2992. PMC 3681085. PMID 23814758.

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