230 Parotid enlargement Instruction Look at this patient’s face. Salient features History • Ask the patient whether the parotids are painful and dry mouth • Ask the patient about dry eyes or use of artificial tears • History of sarcoidosis • History of lymphoma, leukaemia. Examination • Bilateral parotid enlargement (Fig. 230.1). Fig. 230.1 Sjögren syndrome with moderate parotid swelling. (With permission from Firestein et al. 2008.) Proceed as follows: • Look for the following conditions: • Dry mouth • Lupus pernio • Rheumatoid arthritis. • Tell the examiner that you would like to know whether the patient has gritty eyes or dry mouth. Remember: Unilateral parotid enlargement with associated facial nerve palsy is more likely to be malignant tumour of the parotids; it is very rare for facial weakness to occur with benign tumours. Diagnosis This patient has parotid enlargement, which is painless, and has a dry mouth (lesion) probably caused by Sjögren syndrome (aetiology). The dry mouth is making swallowing difficult (functional status). Questions What are the causes of painless bilateral parotid enlargement? • Sarcoidosis • Sjögren syndrome or keratoconjunctivitis sicca • Lymphoma and leukaemia. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window)Like this:Like Loading... Related Related posts: Permanent cardiac pacemaker/implantable cardioverter-defibrillator Cauda equina syndrome Dermatomyositis Arteriovenous fistula Stay updated, free articles. Join our Telegram channel Join Tags: 250 Cases in Clinical Medicine Dec 4, 2016 | Posted by admin in GENERAL & FAMILY MEDICINE | Comments Off on Parotid enlargement Full access? Get Clinical Tree
230 Parotid enlargement Instruction Look at this patient’s face. Salient features History • Ask the patient whether the parotids are painful and dry mouth • Ask the patient about dry eyes or use of artificial tears • History of sarcoidosis • History of lymphoma, leukaemia. Examination • Bilateral parotid enlargement (Fig. 230.1). Fig. 230.1 Sjögren syndrome with moderate parotid swelling. (With permission from Firestein et al. 2008.) Proceed as follows: • Look for the following conditions: • Dry mouth • Lupus pernio • Rheumatoid arthritis. • Tell the examiner that you would like to know whether the patient has gritty eyes or dry mouth. Remember: Unilateral parotid enlargement with associated facial nerve palsy is more likely to be malignant tumour of the parotids; it is very rare for facial weakness to occur with benign tumours. Diagnosis This patient has parotid enlargement, which is painless, and has a dry mouth (lesion) probably caused by Sjögren syndrome (aetiology). The dry mouth is making swallowing difficult (functional status). Questions What are the causes of painless bilateral parotid enlargement? • Sarcoidosis • Sjögren syndrome or keratoconjunctivitis sicca • Lymphoma and leukaemia. Only gold members can continue reading. Log In or Register to continue Share this:Click to share on Twitter (Opens in new window)Click to share on Facebook (Opens in new window)Like this:Like Loading... Related Related posts: Permanent cardiac pacemaker/implantable cardioverter-defibrillator Cauda equina syndrome Dermatomyositis Arteriovenous fistula Stay updated, free articles. Join our Telegram channel Join Tags: 250 Cases in Clinical Medicine Dec 4, 2016 | Posted by admin in GENERAL & FAMILY MEDICINE | Comments Off on Parotid enlargement Full access? Get Clinical Tree
