A comprehensive clinical examination is the basis for selecting further diagnostic steps:
- General physical examination – including blood pressure, pulse, body temperature, body weight, height [short stature?]; further:
- Inspection (viewing).
- Skin and mucous membranes [marked amount and size of benign (benign) nevi (moles)?]
- Face [more extensive face?]
- Eyes [due tosecondary disease keratoconus (progressive, cone-shaped deformation of the cornea of the eye)]
- Neck, nape [pterygium colli (wing-shaped lateral neck folds/wing fur)? Deep-seated hairline on the nape of the neck?]
- Thorax (thorax) [shield thorax (broad as well as flat thorax (thorax) incl. wide nipple spacing (distance between nipples))? Funnel chest (pectus excavatum)?]
- Abdominal wall and inguinal region (groin area).
- Hands and dorsum of the feet [lymphedema (storage of lymphatic fluid in the tissue)?]
- Auscultation (listening) of the heart [due tosequelae heart defect].
- Inspection (viewing).
- Gynecological examination
- Inspection
- Vagina (vaginal) [vaginal hypoplasia (minor development of the vagina (vagina))?]
- Pectoralis muscle (large chest muscle) [hypoplasia (underdevelopment) or complete absence [due todifferential diagnosis Poland syndrome (absence of a pectoralis muscle and malformation of the ipsilateral mammary gland)]]
- Palpation (palpation) of the internal genital organs – bimanual (ambidextrous).
- Uterus (uterus) [uterine hypolasia (minor development of the uterus (uterus))?]
- Adnexa (appendages of the uterus, i.e., the ovary (ovary) and uterine tubule (fallopian tube)) [Streak gonads (dysgenesis (malformation) of the ovaries (ovaries) = fibrous strands)?]
- Douglas space (pocket-like bulge of the peritoneum (peritoneum) between the rectum (rectum) behind and uterus (uterus) in front) [uterine hypolasia (minor development of the uterus)?]
- Examination of the mammae (breasts)
- Inspection of the mammae (breasts), nipples (nipple) and skin [underdevelopment of secondary sexual characteristics and greater spacing of the nipples?]
- Palpation of the mammae, both supraclavicular pits (upper clavicular pits) and axillae (axillae) [underdevelopment of secondary sexual characteristics?]
- Inspection
- Dermatological examination [due tosecondary disease nail dysplasias (nail malformations)]
- ENT medical examination [due tosecondary disease hypacusis (hearing loss)]
- Orthopedic examination [due tosecondary disease osteoporosis (bone loss)]
- Endocrinological examination [due tosecondary diseases diabetes mellitus type 1, hypothyroidism (hypothyroidism)]
Square brackets [ ] indicate possible pathological (pathological) physical findings.