Rhabdomyosarcoma physical examination: Difference between revisions

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{{Rhabdomyosarcoma}}
{{Rhabdomyosarcoma}}
{{CMG}}<nowiki>; {AE}} </nowiki>{{S.M}}
{{CMG}}; {{AE}} {{S.M}}
==Overview==
==Overview==
==Physical Examination==
==Physical Examination==
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===Abdomen===
===Abdomen===
* Abdominal examination of patients with  is usually normal.
* Abdominal examination of patients with  is usually normal.
OR
*[[Abdominal distension]]
*[[Abdominal tenderness]] in the right/left upper/lower abdominal quadrant
*[[Rebound tenderness]] (positive Blumberg sign)
*A palpable abdominal mass in the right/left upper/lower abdominal quadrant
*Guarding may be present
*[[Hepatomegaly]] / [[splenomegaly]] / [[hepatosplenomegaly]]
*Additional findings, such as obturator test, psoas test, McBurney point test, Murphy test


===Back===
===Back===
* Back examination of patients with [disease name] is usually normal.
* Back examination of patients with rhabdomyosarcoma is usually normal.
OR
*Point tenderness over __ vertebrae (e.g. L3-L4)
*Sacral edema
*Costovertebral angle tenderness bilaterally/unilaterally
*Buffalo hump


===Genitourinary===
===Genitourinary===
* Genitourinary examination of patients with [disease name] is usually normal.
* Genitourinary examination of patients with rhabdomyosarcoma depends on tumor site.
OR
** Vaginal tumors may have polypoid mass protrusion and/ or mucosanguineous discharge.
*A pelvic/adnexal mass may be palpated
** Paratesticular tumors may have nontender scrotal or inguinal mass.
*Inflamed mucosa
*Clear/(color), foul-smelling/odorless penile/vaginal discharge
 
===Neuromuscular===
===Neuromuscular===
* Neuromuscular examination of patients with [disease name] is usually normal.
* Neuromuscular examination of patients with rahbdomyosarcoma 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===
* Extremities examination of patients with [disease name] is usually normal.
* Extremities examination of patients with rhabdomyosarcoma may have tender or nontender mass.
OR
*[[Clubbing]]
*[[Cyanosis]]
*Pitting/non-pitting [[edema]] of the upper/lower extremities
*Muscle atrophy
*Fasciculations in the upper/lower extremity
 
 


==References==
==References==

Revision as of 04:48, 2 February 2019

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

Overview

Physical Examination

  • Physical examination findings depend on the tumor origin and the presence or absence of metastases.[1]
  • Physical examination of patients with rhabdomyosarcoma is usually remarkable for nontender, palpable mass.

Appearance of the Patient

  • Patients with rhabdomyosarcoma usually have normal appearance.

Vital Signs

  • Fever may be present

Skin

  • Skin examination of patients with Rhabdomyosarcoma may be erythmatous.

HEENT

  • HEENT examination of patients with rhabdomyosarcoma depends on tumor site.
  • Abnormal physical examination findings are:[2]
    • Proptosis
    • Ophtalmoplasia
    • Dysconjugate gaze
    • Presence of localized nontender enlarging mass

Neck

  • Neck examination of patients with rhabdomyosarcoma may be presence of nontender enlarging mass.

Lungs

  • Pulmonary examination of patients with metastatic rhabdomyosarcoma may be infavor of pleural effusion.

Heart

  • Cardiovascular examination of patients with rhabdomyosarcoma is usually normal.

Abdomen

  • Abdominal examination of patients with is usually normal.

Back

  • Back examination of patients with rhabdomyosarcoma is usually normal.

Genitourinary

  • Genitourinary examination of patients with rhabdomyosarcoma depends on tumor site.
    • Vaginal tumors may have polypoid mass protrusion and/ or mucosanguineous discharge.
    • Paratesticular tumors may have nontender scrotal or inguinal mass.

Neuromuscular

  • Neuromuscular examination of patients with rahbdomyosarcoma is usually normal.

Extremities

  • Extremities examination of patients with rhabdomyosarcoma may have tender or nontender mass.

References

  1. Maurer HM, Beltangady M, Gehan EA, Crist W, Hammond D, Hays DM; et al. (1988). "The Intergroup Rhabdomyosarcoma Study-I. A final report". Cancer. 61 (2): 209–20. PMID 3275486.
  2. Rao AA, Naheedy JH, Chen JY, Robbins SL, Ramkumar HL (2013). "A clinical update and radiologic review of pediatric orbital and ocular tumors". J Oncol. 2013: 975908. doi:10.1155/2013/975908. PMC 3610355. PMID 23577029.

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