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 the mucous membranes
- Auscultation (listening) of the heart.
- Auscultation of the lungs
- Palpation (palpation) of the abdomen (abdomen) (tenderness?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, renal bearing knocking pain?) [Leading symptom in infants: diarrhea (diarrhea).
- Inspection (viewing).
- Cancer screening [due topossible causes of diabetes insipidus centralis:
- Malignant neoplasms of the blood system such as leukemia (blood cancer) or lymphoma (neoplasm originating from the lymphatic system).
- Granulomas (nodular neoplasms) such as histiocytosis X or xanthoma disseminatum.
- Neoplasms in the region of the head, unspecified.
- Metastases (daughter tumors) in the area of the head, not specified
- Tumor or cyst of the pituitary gland or hypothalamus]
[due topossible causes of renal diabetes insipidus: sarcoma (malignant tumor originating in soft tissue)]
- If necessary, gynecological examination [due topossible cause of diabetes insipidus centralis as well as renal diabetes insipidus: pregnancy]
- Neurological examination [due topossible causes of diabetes insipidus centralis:
- Chronic meningitis (meningitis).
- Hypoxic encephalopathy (damage to the brain caused by lack of oxygen).
- Viral encephalitis (inflammation of the brain caused by viruses)]
[due toPossible cause of renal diabetes insipidus: neurosarcoidosis (inflammatory systemic disease affecting the skin, lungs, and in this case, the nervous system)]
- If necessary, psychiatric examination [due todifferential diagnosis: psychogenic polydipsia (pathologically increased sense of thirst)]
- Urological/nephrological examination [due topossible causes of renal diabetes insipidus:
- Chronic pyelonephritis (inflammation of the renal pelvis).
- Renal ischemia (acute tubular necrosis) (cell death in the kidney caused by damage from drugs or toxins)
- Renal cysts
- Obstruction (shifting/blockage) of ureter (ureter) or urethra]
- Health check
Square brackets [ ] indicate possible pathological (pathological) physical findings.