Focused Physical Examination in a Patient with Osteoporosis
| Component of physical exam | Example of finding of potential skeletal importance | Potential clinical implications for skeletal health |
|---|---|---|
| Vital signs | Low body weight or body mass index | Anorexia nervosa |
| Loss of height | Vertebral fracture | |
| Loss of weight | Malignancy, malabsorption | |
| Skin | Urticaria pigmentosa Dermatitis herpetiformis | Systemic mastocytosis Celiac disease |
| Striae, acne | Cushing’s syndrome, exogenous glucocorticoids | |
| Head | Cranial dysostosis | Hypophosphatasia |
| Eyes | Blue sclera | Osteogenesis imperfect |
| Ears | Hearing loss | Osteogenesis imperfecta, sclerosteosis |
| Nose | Anosmia | Kallmann syndrome |
| Throat | Poor dentition | Increased risk of osteonecrosis of the jaw |
| Neck | Thyromegaly | Thyrotoxicosis |
| Lungs | Decreased breath sounds | Chronic obstructive pulmonary disease |
| Heart | Aortic insufficiency | Marfan’s syndrome |
| Musculoskeletal | Kyphosis | Vertebral fractures |
| Spinous process tenderness | Acute vertebral fracture | |
| Decreased space between lower ribs and pelvis | Vertebral fractures | |
| Tender bones | Osteomalacia | |
| Inflammatory joint disease | Rheumatoid arthritis | |
| Hypermobility of joints | Ehlers-Danlos syndrome | |
| Muscle weakness | Vitamin D deficiency, osteomalacia | |
| Abdomen | Hepatomegaly | Chronic liver disease |
| Surgical scars | Bariatric surgery, gastrectomy | |
| Genitalia | Testicular atrophy | Hypogonadism |
| Neurological | Poor balance | High fall risk, vitamin D deficiency |
| Dementia | Poor adherence to therapy, high fall risk |
This table provides examples of findings on physical exam that may be helpful in the evaluation of skeletal health. It is not intended to show all findings of importance.
From: Osteoporosis: Clinical Evaluation
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