Which physical findings suggest pediatric Crohn disease?

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

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