Pulmonary nodule physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

Patients with pulmonary nodule usually are well-appearing. Physical examination of patients with pulmonary nodule usually has no remarkable findings. In some cases, solitary pulmonary nodule may show findings associated with the underlying condition.

Physical Examination

• The following physical examination findings may be present among patients with pulmonary nodule:

General appearance

• Well-appearing
• Older age in relation to chronological age
• Lethargic
• Confused

Vital Signs

• Decreased SPO2
• Tachypnea
• Tachycardia

Chest

Inspection

• Hoarseness
• Rapid rate of breathing

Auscultation

• Present pleural friction rub
• Present egophony
• Crackling or bubbling noises
• Present whispered pectoriloquy
• Decreased/absent breath sounds

Percussion

• Hyporesonance
• Dull percussion
• Tactile fremitus
• Reduced chest expansion

Abdomen

• Hepatomegaly

Musculoskeletal

• Palpable soft-tissue mass
• Deformity of metacarpophalangeal ​joints (Boutonniere deformity)

• Present in rheumatoid nodule

Skin

• Pallor
• Acanthosis nigricans

HEENT

• Lymphadenopathy

CNS

• Slurred speech
• Confusion

Extremities

• Clubbing of fingers
• Swelling of hands and feet
• Weakness
• Absent pulse