Which physical findings are characteristic of chronic fatigue syndrome (CFS)?

Updated: Aug 29, 2018
  • Author: Jefferson R Roberts, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Physical examination often reveals no abnormalities. Some patients may have positive orthostatic vital signs.

Many patients with or without CFS have small, moveable, painless lymph nodes that most commonly involve the neck, axillary region, or inguinal region. A single lymph node that is very large, tender, or immobile suggests a diagnosis other than CFS. Similarly, generalized adenopathy suggests a diagnosis other than CFS.

In the oropharynx, purple or crimson crescent discoloration of both anterior tonsillar pillars in the absence of pharyngitis is a frequent marker in patients with CFS. The cause of crimson crescents is unknown, but they are common in patients with CFS. Nonetheless, crimson crescents are not specific for CFS.

Trigger points, which suggest fibromyalgia, are absent in patients with CFS. Fibromyalgia and CFS rarely coexist in the same patient.

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