Vasculitis physical examination: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
 
(25 intermediate revisions by 5 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Vasculitis}}
{{Vasculitis}}
 
{{CMG}}; {{AE}} {{MUT}} {{JH}} {{KS}}
{{CMG}}; '''Associate Editor-In-Chief:''' {{MUT}}


==Overview==
==Overview==
Line 18: Line 17:
====Blood Pressure====
====Blood Pressure====
* At least 10 mmHg [[cardiac cycle|systolic]] difference in both arms -  in [[Takayasu arteritis]]
* At least 10 mmHg [[cardiac cycle|systolic]] difference in both arms -  in [[Takayasu arteritis]]
* New onset diastolic blood pressure > 90 mmHg - [[Polyarteritis nodosa]]
===Skin===
===Skin===
* Palpable [[purpura]] - if patients have this in isolation, it is most likely due to cutaneous leukocytoclastic vasculitis. If the purpura is in combination with systemic organ involvement, it is most likely to be Henoch-Schonlein purpura or microscopic polyarteritis.
* Palpable [[purpura]] - if patients have this in isolation, it is most likely due to cutaneous leukocytoclastic vasculitis. If the purpura is in combination with systemic organ involvement, it is most likely to be Henoch-Schonlein purpura or microscopic polyarteritis.
* [[Livedo reticularis]] - [[Polyarteritis nodosa]]
* Erythema of palms/soles, edema of hands/feet, periungual desquamation, polymorphous rash -  [[Kawasaki disease]]
* Palpable [[purpura]], maculopapular rash - [[Hypersensitivity vasculitis]]


===Head===
* Tenderness on the sides of the head - [[Temporal arteritis]]
* Tenderness on the head may be present in [[Takayasu arteritis]]
===Heart===
====Auscultation====
* [[Bruit]] over one or both [[carotid arteries]] or abdominal aorta - [[Takayasu arteritis]]
===Extremities===
(Images courtesy of Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, CA)
(Images courtesy of Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, CA)


Line 47: Line 42:
| [[Image:Skin_vasculitis7.jpg|thumb|Vasculitis: In this instance, idiopathic.]]
| [[Image:Skin_vasculitis7.jpg|thumb|Vasculitis: In this instance, idiopathic.]]
| [[Image:skin_vasculitis5.jpg|thumb|Vasculitis: In this instance, idiopathic with palpable purpura.]]
| [[Image:skin_vasculitis5.jpg|thumb|Vasculitis: In this instance, idiopathic with palpable purpura.]]
|}
|}
<br clear="left"/>
<br clear="left"/>
'''Images of [[vasculitis]] after Streptococcal throat infection'''
[[File:Strep vasculitis 1.jpg|Streptococcal vasculitis|left|300px]]
[[File:Strep vasculitis 2.jpg|Streptococcal vasculitis|left|300px]]
<br style="clear:left" />
===Eye===
* Bilateral conjunctival injection - [[Kawasaki disease]]
===Head===
* Tenderness on the sides of the head - [[Temporal arteritis]]
* Tenderness on the head may be present in [[Takayasu arteritis]]
* Nasal or oral inflammation (oral ulcers or purulent/bloody nasal discharge, may be painful) - [[Wegener's granulomatosis]]
* Cervical lymphadenopathy (at least one node > 1.5 cm), injected or fissured lips, injected pharynx, or strawberry tongue - [[Kawasaki disease]]
===Heart===
====Auscultation====
* [[Bruit]] over one or both [[carotid arteries]] or abdominal aorta - [[Takayasu arteritis]]
===Extremities===
* Claudication
===Gallery===
====Lower extremity====
<gallery>
Image:Allergic vasculitis_01.jpeg|Allergic vasculitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=22  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=22>
Image:Allergic vasculitis_02.jpeg|Allergic vasculitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=22  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=22>
Image:Allergic vasculitis_03.jpeg|Allergic vasculitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=22  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=22>
Image:Allergic vasculitis_04.jpeg|Allergic vasculitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=22  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=22>
Image:Allergic vasculitis_05.jpeg|Allergic vasculitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=22  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?diseaseId=22>
Image:Allergic vasculitis_06.jpeg|Allergic vasculitis. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=22  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://atlasdermatologico.com.br/disease.jsf?
diseaseId=22>
Image:Allergicvasculitis07.jpg|.Allergicvasculitis <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Allergicvasculitis08.jpg|.Allergicvasculitis <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Allergicvasculitis09.jpg|.Allergicvasculitis <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Allergicvasculitis10.jpg|.Allergicvasculitis <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Allergicvasculitis11.jpg|.Allergicvasculitis <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Allergicvasculitis12.jpg|.Allergicvasculitis <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Allergicvasculitis13.jpg|.Allergicvasculitis <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
Image:Allergicvasculitis14.jpg|.Allergicvasculitis <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/  Adapted from Dermatology Atlas.]''<ref name="Dermatology Atlas">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/}}</ref></SMALL></SMALL>
</gallery>
===Neurologic===
* [[Mononeuropathy]] or [[polyneuropathy]] - [[Polyarteritis nodosa]], [[Churg-Strauss syndrome|Churg-Strauss arteritis]]


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Rheumatology]]


{{WH}}
{{WH}}
{{WS}}
{{WS}}

Latest revision as of 17:47, 19 June 2017

Vasculitis

Overview

Classification

Large-sized vessel vasculitis
Takayasu's Arteritis
Temporal Arteritis
Medium-sized vessel vasculitis
Kawasaki's Disease
Polyarteritis Nodosa
Small-sized vessel vasculitis
Churg-Strauss Syndrome
Cutaneous leukocytoclastic vasculitis
Essential cryoglobulinemic vasculitis
Henoch-Schonlein Purpura
Microscopic polyangiitis
Wegener's Granulomatosis
Variable-sized vessel vasculitis
Sjogren syndrome
Cogan syndrome
Single organ vasculitis
Primary central nervous system angiitis

Causes

Differential Diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: M.Umer Tariq [2] Jesus Rosario Hernandez, M.D. [3] Kiran Singh, M.D. [4]

Overview

Physical Examination

Vitals

Temperature

  • Elevated body temperature may be present (fever)

Pulse

Rate
Strength

Blood Pressure

Skin

  • Palpable purpura - if patients have this in isolation, it is most likely due to cutaneous leukocytoclastic vasculitis. If the purpura is in combination with systemic organ involvement, it is most likely to be Henoch-Schonlein purpura or microscopic polyarteritis.
  • Livedo reticularis - Polyarteritis nodosa
  • Erythema of palms/soles, edema of hands/feet, periungual desquamation, polymorphous rash - Kawasaki disease
  • Palpable purpura, maculopapular rash - Hypersensitivity vasculitis

(Images courtesy of Charlie Goldberg, M.D., UCSD School of Medicine and VA Medical Center, San Diego, CA)

Skin:Leucocytolastic vasculitis; legs
Leucocytoclastic vasculitis; pustular type
Vasculitis: In this instance, the vasculitic skin lesions were secondary to Haemophilus endocarditis.
Vasculitis: In this instance, the vasculitic skin lesions were secondary to Haemophilus endocarditis.


Vasculitis: In this instance, idiopathic with palpable purpura.
Vasculitis: Palpable Purpura: Secondary to idiopathic leukocytoplastic vasculitis.
Vasculitis: In this instance, idiopathic.
Vasculitis: In this instance, idiopathic with palpable purpura.



Images of vasculitis after Streptococcal throat infection

Streptococcal vasculitis
Streptococcal vasculitis
Streptococcal vasculitis
Streptococcal vasculitis


Eye

Head


Heart

Auscultation

Extremities

  • Claudication

Gallery

Lower extremity

Neurologic


References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 "Dermatology Atlas".

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Vasculitis_physical_examination&oldid=1318889"