A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body weight, height [obesity (overweight)]; furthermore:
- Inspection (viewing).
- Skin and mucous membranes
- Inspection and palpation (palpation) of the mammae (mammary glands) [exclusion of lipomastia (form of pseudogynecomastia occurring in obese men; enlargement of the breast due to increased adipose tissue); mammary gland tissue > 4 cm in diameter, unilateral/bilateral; tenderness to touch; very rare: Galactorrhea/diseased breast milk discharge [due todifferential diagnosis hyperprolactinemia/elevation of blood prolactin level]; assessment of pubertal development according to Tanner (see below)].
- Inspection and palpation of the abdomen (belly), inguinal region (groin region), etc. (pressure pain?, knock pain?, release pain?, cough pain?, defensive tension?, hernial orifices?, kidney bearing knock pain?)
- Inspection and palpation of the genitals (penis and scrotum; assessment of pubes hair (pubic hair), penis (penis length: in flaccid state between 7-10 cm; presence of: Indurations (tissue hardening), anomalies, phimosis / foreskin constriction?) and testicular position and size (if necessary, by orchimeter); assessment of pubertal development according to Tanner (see below) Note: According to EEA guideline, a palpable (palpable) testicular tumor should be excluded or detected in the presence of testicular atrophy (“shrunken testis”).
- Inspection (viewing).
- Cancer screening
- Health check
Square brackets [ ] indicate possible pathological (pathological) physical findings.
Pubertal development according to Tanner
| Feature | Designation | Brief description |
| Pubes hair | P1 | No difference with the environment |
| P2 | Sparse little pigmented smooth hairs at the base of the penis | |
| P3 | Hair darker, curled, visible from a distance | |
| P4 | Same as adult, but smaller extension | |
| P5 | Adult, horizontal boundary at top, transition to inner thigh | |
| P6 | Adult, spreading along linea alba (vertical suture of connective tissue in the middle of the abdomen formed by the union of the tendon plates of the lateral abdominal muscles) | |
| Chest | B1 | No glandular body palpable, contour of nipple (breast) visible |
| B2 | Glandular body ≤ areola palpable, slight elevation visible | |
| B3 | Glandular body > areola, flowing contour between areola and thoracic body. | |
| B4 | Adult, contour of areola lifted | |
| B5 | Adult, rounded contour | |
| Genital | G1 | Prepubertal, testicular volume ≤ 3 ml. |
| G2 | Testes (testis) slightly enlarged, scrotal skin wrinkled | |
| G3 | Testes and penis larger | |
| G4 | Penis larger, contour of glans penis (glans) visible | |
| G5 | Testes and penis adult |
