Cystitis physical examination: Difference between revisions

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==Overview==
==Overview==
Patients with cystitis are usually well-appearing. Common physical examination findings of cystitis include [[fever]] and suprapubic tenderness. A focused physical examination is helpful in confirming the suspicion of cystitis and in ruling out alternate pathology.
Patients with cystitis are usually well-appearing. Common physical examination finding of cystitis includes suprapubic [[tenderness]]. A focused [[physical examination]] is helpful in confirming the suspicion of cystitis and in ruling out alternate [[pathology]].


==Physical Examination==
==Physical Examination==
The following features can be found during a physical examination of a patient with cystitis. The patient must be in supine position to facilitate a proper examination.<ref>{{cite book |last = Bennett |first = John |title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases |publisher = Elsevier/Saunders |location = Philadelphia, PA |year = 2015 |isbn=9781455748013}}</ref>
The following features can be found during a [[physical examination]] of a patient with cystitis. The patient must be in [[supine position]] to facilitate a proper examination.<ref>{{cite book |last = Bennett |first = John |title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases |publisher = Elsevier/Saunders |location = Philadelphia, PA |year = 2015 |isbn=9781455748013}}</ref>


===General Appearance of the Patient===
===General Appearance of the Patient===
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=== Skin ===
=== Skin ===
* Skin examination of patients with pyelonephritis is usually normal.
* Skin examination of patients with cystitis is usually normal.


=== HEENT ===
=== HEENT ===
* HEENT examination of patients with pyelonephritis is usually normal.
* HEENT examination of patients with cystitis is usually normal.


=== Neck ===
=== Neck ===
* Neck examination of patients with pyelonephritis is usually normal.
* Neck examination of patients with cystitis is usually normal.


=== Lungs ===
=== Lungs ===
* Pulmonary examination of patients with pyelonephritis is usually normal.
* Pulmonary examination of patients with cystitis is usually normal.


=== Heart ===
=== Heart ===
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===Abdomen===
===Abdomen===
* [[Costovertebral angle]] tenderness
* Suprapubic [[tenderness]]<ref name="pmid22010614" />
* Positive sonopalpation test of the kidney<ref name="pmid28050884">{{cite journal| author=Faust JS, Tsung JW| title=Eliciting renal tenderness by sonopalpation in diagnosing acute pyelonephritis. | journal=Crit Ultrasound J | year= 2017 | volume= 9 | issue= 1 | pages= 1 | pmid=28050884 | doi=10.1186/s13089-016-0056-6 | pmc=5215196 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28050884  }} </ref>
* Suprapubic [[tenderness]]
 
===Digital rectal examination (DRE)===
A [[digital rectal exam]] is a procedure performed in an office setting. The patient bends on a table or lays on one side with knees touching chest. The physician wears gloves, applies a lubricant to the gloved finger and enters it into the rectum to feel the prostate normally located in front of the rectum.
*If pyelonephritis is suspected in men, a [[Digital rectal examination|DRE]] helps to differentiate if the obstruction is due to a swollen [[prostate gland]].


=== Back ===
=== Back ===
* [[Costovertebral angle]] tenderness
* Back examination of patients with cystitis is usually normal.


===Genitourinary===
===Genitourinary===
The following findings may be found on genitourinary examination of a patient with pyelonephritis:<ref name="pmid22010614">{{cite journal| author=Colgan R, Williams M| title=Diagnosis and treatment of acute uncomplicated cystitis. | journal=Am Fam Physician | year= 2011 | volume= 84 | issue= 7 | pages= 771-6 | pmid=22010614 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22010614  }} </ref><ref name="pmid20353145">{{cite journal |vauthors=Brill JR |title=Diagnosis and treatment of urethritis in men |journal=Am Fam Physician |volume=81 |issue=7 |pages=873–8 |year=2010 |pmid=20353145 |doi= |url=}}</ref><ref>{{cite book |last = Bennett |first = John |title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases |publisher = Elsevier/Saunders |location = Philadelphia, PA |year = 2015 |isbn=9781455748013}}</ref>
*[[Tenderness|Suprapubic tenderness]]<ref name="pmid22010614">{{cite journal| author=Colgan R, Williams M| title=Diagnosis and treatment of acute uncomplicated cystitis. | journal=Am Fam Physician | year= 2011 | volume= 84 | issue= 7 | pages= 771-6 | pmid=22010614 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22010614  }} </ref><ref name="pmid20353145">{{cite journal |vauthors=Brill JR |title=Diagnosis and treatment of urethritis in men |journal=Am Fam Physician |volume=81 |issue=7 |pages=873–8 |year=2010 |pmid=20353145 |doi= |url=}}</ref><ref>{{cite book |last = Bennett |first = John |title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases |publisher = Elsevier/Saunders |location = Philadelphia, PA |year = 2015 |isbn=9781455748013}}</ref>
 
*[[Tenderness|Suprapubic tenderness]]
*[[Urethral discharge]] (if the cause is urethritis)
*[[Urethral discharge]] (if the cause is urethritis)
*[[Lymphadenopathy|Inguinal lymphadenopathy]]
*Examination of the scrotum and the pubic area must be done


===Neuromuscular===
===Neuromuscular===
* Patient is usually oriented to persons, place, and time.
* Patient is usually oriented to persons, place, and time.
* The following neurological signs can rarely be witnessed in elderly:
**[[Delirium]]
**[[Hallucinations]]


=== Extremities ===
=== Extremities ===
* Extremities examination of patients with pyelonephritis is usually normal.
* Extremities examination of patients with cystitis is usually normal.
 
===Genitourinary===
The following findings may be found on genitourinary examination of a patient with cystitis.<ref name="pmid22010614">{{cite journal| author=Colgan R, Williams M| title=Diagnosis and treatment of acute uncomplicated cystitis. | journal=Am Fam Physician | year= 2011 | volume= 84 | issue= 7 | pages= 771-6 | pmid=22010614 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22010614  }} </ref><ref name="pmid20353145">{{cite journal |vauthors=Brill JR |title=Diagnosis and treatment of urethritis in men |journal=Am Fam Physician |volume=81 |issue=7 |pages=873–8 |year=2010 |pmid=20353145 |doi= |url=}}</ref><ref>{{cite book |last = Bennett |first = John |title = Mandell, Douglas, and Bennett's principles and practice of infectious diseases |publisher = Elsevier/Saunders |location = Philadelphia, PA |year = 2015 |isbn=9781455748013}}</ref>.
 
*Suprapubic tenderness
*[[Urethral discharge]](if the cause is urethritis)
*Inguinal [[lymphadenopathy]]
*Examination of the scrotum and the pubic area must be done
 
===Abdominal===
The following findings can be found on abdominal examination of cystitis.<ref name="pmid22010614">{{cite journal| author=Colgan R, Williams M| title=Diagnosis and treatment of acute uncomplicated cystitis. | journal=Am Fam Physician | year= 2011 | volume= 84 | issue= 7 | pages= 771-6 | pmid=22010614 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22010614  }} </ref>
 
*[[Abdominal tenderness]] on palpation
 
===Cardiovascular===
*[[Tachycardia]]
 
===Neurological===
*[[Delirium]]


==References==
==References==

Revision as of 14:23, 14 June 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Maliha Shakil, M.D. [2], Usama Talib, BSc, MD [3]

Overview

Patients with cystitis are usually well-appearing. Common physical examination finding of cystitis includes suprapubic tenderness. A focused physical examination is helpful in confirming the suspicion of cystitis and in ruling out alternate pathology.

Physical Examination

The following features can be found during a physical examination of a patient with cystitis. The patient must be in supine position to facilitate a proper examination.[1]

General Appearance of the Patient

  • Patients with cystitis are usually normal in appearance and not in distress.[2]

Vital Signs

Skin

  • Skin examination of patients with cystitis is usually normal.

HEENT

  • HEENT examination of patients with cystitis is usually normal.

Neck

  • Neck examination of patients with cystitis is usually normal.

Lungs

  • Pulmonary examination of patients with cystitis is usually normal.

Heart

Abdomen

Back

  • Back examination of patients with cystitis is usually normal.

Genitourinary

Neuromuscular

  • Patient is usually oriented to persons, place, and time.

Extremities

  • Extremities examination of patients with cystitis is usually normal.

References

  1. Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 9781455748013.
  2. 2.0 2.1 2.2 Colgan R, Williams M (2011). "Diagnosis and treatment of acute uncomplicated cystitis". Am Fam Physician. 84 (7): 771–6. PMID 22010614.
  3. Chang SL, Shortliffe LD (2006). "Pediatric urinary tract infections". Pediatr Clin North Am. 53 (3): 379–400, vi. doi:10.1016/j.pcl.2006.02.011. PMID 16716786.
  4. Azzarone G, Liewehr S, O'Connor K (2007). "Cystitis". Pediatr Rev. 28 (12): 474–6. doi:10.1542/pir.28-12-474. PMID 18055650.
  5. Brill JR (2010). "Diagnosis and treatment of urethritis in men". Am Fam Physician. 81 (7): 873–8. PMID 20353145.
  6. Bennett, John (2015). Mandell, Douglas, and Bennett's principles and practice of infectious diseases. Philadelphia, PA: Elsevier/Saunders. ISBN 9781455748013.


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