A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body weight, height; further:
- Inspection (viewing):
- Skin and mucous membranes
- Abdomen (abdomen):
- Shape of the abdomen?
- Skin color? Skin texture?
- Efflorescences (skin changes)?
- Pulsations? Bowel movements?
- Visible vessels?
- Scars? Hernias (fractures)?
- Auscultation (listening) of the heart.
- Auscultation of the lungs
- Palpation (palpation) of the abdomen (tenderness?, tapping pain?, coughing pain?, guarding?, hernial orifices?] [pain in the lower abdomen (suprapubic pain)?)
- Palpation of the renal region [If fever and back or flank pain occur, pyelonephritis, i.e., involvement of the upper urinary tract, such as ureters and/or kidneys including renal pelvis, is very likely].
- Digital rectal examination (DRU): examination of the rectum and adjacent organs with the finger by palpation: assessment of the prostate in size, shape and consistency[due topossible cause: benign prostatic hyperplasia (BPH; benign prostatic enlargement)] [due todifferential diagnosis: chronic prostatitis (inflammation of the prostate).
- Inspection (viewing):
- Gynecological examination [due topossible cause: pregnancy; due todifferential diagnoses]inspection.
- Vulva (external, primary female sex organs) [due todifferential diagnosis: vulvovaginitis (inflammation of the vulva and vagina (vagina)]
- Vagina (vagina) [due todifferential diagnosis: vaginitis (vaginitis)]
- Urological/nephrological examination – if vesicorenal reflux is suspected (synonyms: vesicoureteral reflux, vesico-uretero-renal reflux (VUR; unphysiological reflux of urine from the bladder via the ureters (ureters) into the renal pelvis).
Square brackets [ ] indicate possible pathologic (pathological) physical findings.