|
Adson’s Sign
|
Paresthesias and loss
of the radial pulse in the arm during abduction and external rotation at the
shoulder. This may be augmented by turning the head to the same side. This
may be a sign of Thoracic Outlet Syndrome, but is also very common in ME/CFS
and FM. |
|
Canadian Clinical
Criteria |
http://www.cfids-cab.org/MESA/ccpc.html |
|
Digit Span |
This is a test of
attention and concentration. The subject is asked to repeat a series of
numbers read to him by the examiner. Test for retention of digits forward
first. When the upper range is determined, test for retention of digits in
reverse. The digits should be spoken at one per second, and not grouped.
Stop after two failures in any given series. Less than 7 digits forward and
5 digits in reverse is abnormal; less than 5 digits forward and 3 digits in
reverse is well below average. Significant difficulty on this test should
trigger consideration of full neuropsychiatric testing.
Suggested digit
series: 518, 6501, 37514, 239715, 4391697. |
|
Hyperextensibility |
Hypermobility of
joints is common in ME/CFS (J Pediatr. 2002 Sep;141(3):421-5) and may be
associated with orthostatic hypotension. For a brief summary see:
http://www.hypermobility.org/whatishms.php
To learn how to
diagnose this disorder see:
http://www.hypermobility.org/beighton.php
A brief treatise on the subject can be
found at:
http://www.jaoa.org/cgi/content/full/106/9/531 |
|
International CFS
Criteria |
http://www.cdc.gov/cfs/cfsfullcasedefinition.htm |
|
Myofascial bands |
Myofascial (or taut)
bands occur when muscle tension or spasm persists. Taut bands are common in
persons with ME/CFS and FM, and may evolve into Myofascial Pain Syndrome
with active triggerpoints if the tension is perpetuated. For more see:
http://www.emedicine.com/pmr/topic84.htm |
|
Orthostatic hypotension
|
Orthostatic
intolerance is common in ME/CFS (J Auton Ner Syst 1999; 75:192-201, Am J Med
1997; 104: 957-964). Many patients exhibit delayed orthostatic hypotension;
smaller subsets exhibit Postural Orthostatic Tachycardia Syndrome or POTS
(http://www.dinet.org/pots_an_overview.htm
) and Neurally Mediated Hypotension (JAMA 1995; 274:961-967,
http://avoca.vicnet.net.au/~mecfs/general/nmh1.html ). |
|
Phelan’s Sign |
Prolonged flexion of
the wrist causes paresthesias of the lower forearm due to compression of the
median nerve. This is a test for median neuropathy (carpal tunnel syndrome).
|
|
Serial 7 Subtraction |
This is a test of
concentration in which the subject is asked to serially subtract 7 from one
hundred as rapidly and as audibly as possible. The average time for
completion is up to 90 seconds, and more than 4 errors is abnormal. It is
not a test of mathematical ability alone. Before arithmetical errors are
noted the subject may demonstrate hesitation or questioning, request a new
start, or become upset or irritable. This should be noted. Abnormalities
should trigger consideration of full neuropsychiatric testing. |
|
Tenderpoints
|
Tenderpoints are
places on the body (18 specific points at 9 bilateral locations) that are
exceptionally sensitive to palpation. Tenderpoints are unique to persons
with fibromyalgia. See
http://www.fibromyalgiasupport.com/fibromyalgia-tenderpoints.htm |
|
Tinel’s Sign |
A tingling sensation
felt in the distal portion of the forearm upon percussion of the skin over
the dorsal wrist. Evidence of median neuropathy (carpal tunnel syndrome). |