A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination-including blood pressure, pulse, body weight, height [increased body weight; centrally emphasized obesity]; further:
- Inspection (viewing).
- Body proportions, face and skin [full moon face (moon face), bull neck or buffalo neck, truncal obesity; fingernails: thin and brittle, furunculosis – occurrence of multiple boils (purulent hair follicle inflammation); vascular wall weakness (→ ecchymoses/purpura (general skin hemorrhage), red complexion, striae rubrae (v. a. abdominal) – red streaks on the skin, hematomas/bruises); hyperpigmentation of the skin (especially nipples, nail bed, fresh scars) and mucous membranes [only with increased ACTH secretion], edema – water retention in the tissues.
- Skin and genitals
- Inspection and palpation (palpation) of the thyroid gland.
- Auscultation (listening) of the heart
- Auscultation of the lungs
- Palpation of the abdomen (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, renal bearing knocking pain?)
- Inspection (viewing).
- Ophthalmologic and neurologic examination: if pituitary adenoma is suspected, examination of visual acuity (visual acuity) and oculomotor function (eye movements).
- Health check
Square brackets [ ] indicate possible pathological (pathological) physical findings.
