Crohn’s Disease: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

• General physical examination – including blood pressure, pulse, body temperature, body weight, body height; furthermore:
  • Inspection (viewing).
    • Skin and mucous membranes [erythema nodosum (nodular erythema), localization: Both extensor sides of the lower leg, on the knee and ankle joints; less commonly on the arms or buttocks, erythema (extensive redness of the skin); pyoderma gangraenosum (painful disease of the skin in which ulceration or ulceration (ulceration or ulceration) occurs over a large area, usually in one place, and gangrene (tissue death due to reduced blood flow or other damage))]
    • Eyes [uveitis (inflammation of the uvea (middle skin of the eye); iridocyclitis (inflammation of the iris); episcleritis (inflammation of the connective tissue between the sclera and conjunctiva of the eye)]
    • 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
  • Examination of the abdomen (belly)
    • Percussion (tapping) of the abdomen
      • Meteorism (flatulence): hypersonoric tapping sound.
      • Attenuation of tapping sound due to enlarged liver or spleen, tumor, urinary retention?
    • Palpation (palpation) of the abdomen (abdomen) (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, renal bearing knocking pain?) [Resistance in the lower abdomen?]
  • Digital rectal examination (DRU): examination of the rectum (rectum) [symptoms that may be added later in the course of the disease: perianal abscesses and fistulas; subileus (incomplete intestinal obstruction)][due todifferential diagnoses:
    • Colitis indeterminata (disease that is a combination of ulcerative colitis and Crohn’s disease).
    • Rectal ulcer (rectal ulcer)]

    [due topossible secondary diseases:

    • Abscess formation
    • Fistulas (tubular connecting ducts between organs, e.g., enterovesical fistula = connecting duct from the intestine to the urinary bladder or cutaneous fistula – connection from the intestine to the skin)
    • Intestinal bleeding (bleeding in the intestine)]
• Cancer screening [due todifferential diagnoses:
  • Familial adenomatous polyposis (FAP; synonym: polyposis coli) – autosomal-dominant inherited disease that causes polyps in the colon.
  • Colon carcinoma (colon cancer)
  • Lymphoma (malignant disease originating in the lymphatic system)]

  [due topossible secondary disease: colon carcinoma (colon or rectal cancer)]

• If necessary, ophthalmological examination [due toextraintestinal manifestations / signs of disease outside the gastrointestinal tract: uveitis (inflammation of the uvea (middle eye skin); iridocyclitis (inflammation of the iris); episcleritis (inflammation of the connective tissue between the sclera and conjunctiva of the eye)]
• If necessary, orthopedic examination [due topossible secondary disease: osteoporosis (bone loss)]
• Urological examination [due topossible symptom: urinary tract infections]
• Health check

Square brackets [ ] indicate possible pathological (pathological) physical findings.