Granulomatosis with Polyangiitis: 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, mucous membranes, and sclerae (white part of the eye) [eyelid edema, lower leg edema (water retention), exophthalmos (protrusion of the eye from the orbit), skin changes such as purpura (pinpoint hemorrhage) or necrosis (tissue breakdown)]
      • Gait pattern [gait unsteadiness, arthralgia (joint pain), myalgia (muscle pain)]
      • 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?, knocking pain?, coughing pain?, defensive tension?, hernial orifices?, kidney bearing knocking pain?)
    • Palpation of vertebral bodies, tendons, ligaments; musculature (tone, tenderness, contractures of paraverebral musculature); soft tissue swelling; tenderness (localization! ; restricted mobility (spinal movement restrictions); “tapping signs” (testing painfulness of spinous processes, transverse processes, and costotransverse joints (vertebral-rib joints) and back muscles); illiosacral joints (sacroiliac joint) (pressure and tapping pain?; compression pain, anterior, lateral or saggital; hyper- or hypomobility?
    • Palpation of prominent bone points, tendons, ligaments; musculature; joint (joint effusion?); soft tissue swelling; tenderness (localization!).
  • Ophthalmological examination – for visual disturbances.
  • ENT examination – because of possible symptoms: chronic otitis media (inflammation of the middle ear), chronic bloody-crusty rhinitis, inflammation of the throat/salivary glands, mastoiditis (purulent inflammation of the bone behind the ear), septal perforation (hole in the nasal septum), ulcerations (ulcers) in the oropharynx (oral pharynx).

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