Which physical findings suggest pediatric Crohn disease?

Updated: Oct 23, 2018
  • Author: Andrew B Grossman, MD; Chief Editor: Carmen Cuffari, MD  more...
  • Print
Answer

Physical examination findings

  • Vital signs are usually normal, although tachycardia may be present in anemic patients

  • Chronic intermittent fever is a common presenting sign

  • Body weight and height may reveal weight loss and growth delay

  • The most sensitive indicator of growth abnormalities is a decrease in growth velocity, which may be observed before the major percentile lines on standard growth curves are crossed

  • Abdominal findings may vary from normal to those of an acute abdomen; diffuse abdominal tenderness is common; fullness or a discrete mass may be palpable, typically in the right lower quadrant

  • Perianal disease (eg, skin tags, abscesses, fistulae, fissures) is present in approximately 45% of patients

  • Tanner staging may indicate pubertal delay, which may precede the onset of intestinal symptoms

  • The most common cutaneous manifestations are erythema nodosum and pyoderma gangrenosum

  • Skin examination may also reveal pallor in patients with anemia or jaundice in those with concomitant liver disease

  • The most common ocular findings are episcleritis and anterior uveitis

  • The most common extraintestinal manifestations of Crohn disease are arthritis and arthralgia, typically involving the large joints (eg, hips, knees, ankles)

See Clinical Presentation for more detail.


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!