Health Dictionary
Reliable, easy-to-read patient information on common medical conditions — written in plain language, free of jargon, and grounded in current evidence. Browse the most frequent diagnoses, understand what they mean for everyday life, and learn which steps and questions help you have a focused conversation with your doctor.
Wegener's granulomatosis physical examination
Introduction
Overview
Overview
The important physical exam findings are Ulcerations, palpable purpura and subcutaneous nodules in the skin; conjunctivitis, uveitis, sinusitis, purulent exudate from nares,saddle nose deformity, reduced hearing in the head and neck; pleuritic chest pain ans signs of atelectasis in lung examination; and signs of mononeuritis multiplex on neural exam.
Physical Examination
Physical Examination
- Physical examination of patients with Granulomatosis with polyangiitis is usually remarkable for:[1][2]
Vital Signs
- They usually have normal vital signs until infected.
Skin
The skin findings are seen in 14% of patients:[3]
- Ulcerations
- Palpable purpura
- Subcutaneous nodules
HEENT
- Scleritis
- Keratitis
- Uveitis
- Conjunctivitis
- Proptosis
- Xanthelasma
- Purulent exudate from the nares
- Sinusitis[4]
- Saddle nose deformity
- Otitis Media
- Hearing acuity may be reduced[1]
- Weber test may be abnormal
- Rinne test may be positive
- Gingival hyperplasia or necrotizing gingivitis[5] can be seen
Neck
- Neck examination of patients with granulomatosis with polyangiitis is usually normal.
Lungs
Examination may show signs of:
- Pleuritic pain
- Atelectasis
- Pleural effusion
- Pulmonary hypertension– bibasilar crackles
- Subglottic stenosis
Heart
Abdomen
- Abdominal tenderness may be present[6]
- Guarding may be present
Back
- Back examination of patients with granulomatosis with polyangiitis is usually normal.
Genitourinary
- A pelvic/adnexal mass may be palpated
- Inflamed mucosa
Neuromuscular
- Patient is usually oriented to persons, place, and time
- Mononeuritis multiplex[7]– Loss of sensory and motor functions
- Cranial nerve paralysis
Extremities
- Extremities examination of patients with granulomatosis with polyangiitis is usually normal.
References
References
- ↑ 1.0 1.1 Seo P, Stone JH (July 2004). “The antineutrophil cytoplasmic antibody-associated vasculitides”. Am. J. Med. 117 (1): 39–50. doi:10.1016/j.amjmed.2004.02.030. PMID 15210387.
- ↑ Graves N (October 2006). “Wegener granulomatosis”. Proc (Bayl Univ Med Cent). 19 (4): 342–4. PMC 1618758. PMID 17106496.
- ↑ Daoud MS, Gibson LE, DeRemee RA, Specks U, el-Azhary RA, Su WP (October 1994). “Cutaneous Wegener’s granulomatosis: clinical, histopathologic, and immunopathologic features of thirty patients”. J. Am. Acad. Dermatol. 31 (4): 605–12. PMID 8089286.
- ↑ Cannady SB, Batra PS, Koening C, Lorenz RR, Citardi MJ, Langford C, Hoffman GS (April 2009). “Sinonasal Wegener granulomatosis: a single-institution experience with 120 cases”. Laryngoscope. 119 (4): 757–61. doi:10.1002/lary.20161. PMID 19263410.
- ↑ Genuis K, Pewarchuk J (September 2014). “Granulomatosis with polyangiitis (Wegener’s) as a necrotizing gingivitis mimic: a case report”. J Med Case Rep. 8: 297. doi:10.1186/1752-1947-8-297. PMC 4168997. PMID 25196320.
- ↑ Pagnoux C, Mahr A, Cohen P, Guillevin L (March 2005). “Presentation and outcome of gastrointestinal involvement in systemic necrotizing vasculitides: analysis of 62 patients with polyarteritis nodosa, microscopic polyangiitis, Wegener granulomatosis, Churg-Strauss syndrome, or rheumatoid arthritis-associated vasculitis”. Medicine (Baltimore). 84 (2): 115–28. PMID 15758841.
- ↑ Anadure R, Narayanan C, Varadraj G, Nandeesh B (January 2017). “ANCA Associated Mononeuritis Multiplex with Overlap in Vasculitic Syndromes”. J Clin Diagn Res. 11 (1): OD01–OD03. doi:10.7860/JCDR/2017/22252.9149. PMC 5324437. PMID 28273992.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Ali Poyan Mehr, M.D. [2]Associate Editor(s)-in-Chief: Amandeep Singh M.D.[3]Krzysztof Wierzbicki M.D. [4]