Nail abnormalities are common and can give invaluable clues to underlying systemic illness. Clubbing is dealt with in a separate section (p. 56). Causes Congenital ● Epidermolysis bullosa ● Anonychia congenita Acquired Infections ● Fungal infection (onychomycosis) ● Paronychia Traumatic…
Muscle weakness and wasting may be caused by a variety of conditions both systemic and those confined to the muscles only. Causes Localised ● Peripheral nerve lesions ● Peripheral nerve compression ● Motor neuropathy ● Peripheral nerve transection ● Disuse…
Mouth ulceration is common but it is important to be able to distinguish between simple benign ulcers (e.g. traumatic or aphthous) and those that are malignant. Tongue disorders are dealt with on p. 431. Causes ● Traumatic ● Aphthous (…
Melaena is the passage of altered blood per rectum (PR). A melaena stool is black and tarry and has a characteristic smell. The blood is degraded by hydrochloric acid and intestinal enzymes high in the gastrointestinal tract. Melaena is unlikely…
Lymphadenopathy is a common presenting condition. It may be localised or generalised. The causes are multiple but a careful history and clinical examination will often simplify the diagnosis. Lymphadenopathy, especially cervical, is extremely common in children who are otherwise healthy.…
Lip lesions are common. They may be extremely painful and interfere with speech and feeding. There is often a social stigma attached for the patient that leads to embarrassment. In the elderly, carcinoma is a common cause of a lump…
An ulcer is a discontinuity of an epithelial surface. Leg ulcers are common and the site of an ulcer on the leg may provide a clue to its aetiology. Causes Infective ● Syphilis ● TB • (common where TB is…
Swelling of the lower limb may be unilateral or bilateral. Bilateral swellings are usually due to medical conditions such as cardiac, renal or hepatic failure. Unilateral swellings are commonly due to trauma, venous disease or lymphatic disease. Causes Local You’re…
This section deals with causes of pain arising from local lesions within the leg, or referred into the leg. Pain in the leg is a common complaint and the majority of cases are of vascular or orthopaedic origin. Joint problems…
Kidney swellings are common. They may present silently or may be associated with haematuria, urinary tract infections and pyrexia. Causes Congenital ● Polycystic kidney Acquired Infective ● Perinephric abscess ● TB • (common where TB is endemic) You’re Reading a…