You perform a physical exam, and discover the following:
General appearance: Older pleasant gentleman, appearing his stated age
Vital signs: T 98.7, HR 78, BP 110/74, RR 16, O2 saturation 98% on room air
Head and neck: Icteric sclerae without jaundice; conjunctival pallor
Chest: Clear to auscultation; breathing comfortably on room air
CVS: S1, S2, no extra heart sounds, no murmurs
Abdomen: Soft, nontender, nondistended; no organomegaly
CNS: Alert and oriented; no focal deficits in strength or sensations
Lymph: No palpable cervical or supraclavicular lymphadenopathy
While performing a careful exam of his extremities, you observe the findings shown in the two images below:
You noted scleral icterus on this patient’s exam, and he reported prior alcohol use to you. His wife is concerned about cirrhosis. Which exam findings would concern you for cirrhosis?
Findings of chronic liver disease are absent on his exam.
Interested in further reading? Refer to the Stanford Medicine page on physical exam findings in liver disease.