SCD – Physical Examination

 Vital signs: fever, tachycardia, collapsing pulse, tachypnea and hypotension.

 Weight and height (BMI).

 Distress: pain or respiratory.

 Jaundice and pallor.

 Gum bleeding.

 Angular stomatitis and glossitis.

 Tonsillitis, otitis or sinusitis. (Cause of crisis).

 Thalassemic features: Bossing, dental malocclusion and maxillary hyperplasia.

 Funduscopic examination.

 JVP (cor pulmonale and pulmonary hypertension).

 Cervical L/N (infection).

 Meningeal signs (nuchal rigidity, Kernig's sign and Brudzinski's sign).

 Clubbing, koilonychias.

 Hyperpigmentation of the skin.

 Digits of varying length.

 Scratch marks, bruises, and palmar erythema.

 Cardiac examination: ESM.

 Pulmonary auscultation: rales or decreased breath sounds.

 Liver and spleen examination.

 Palpate for tenderness (chest, abdomen, extremities, and back).

 Hip tenderness.

 Look for priapism (in case of pain).

 Signs of osteomyelitis, including tenderness, edema, and erythema.

 Leg ulcers.

 Lower limb edema (CHF).

 Neurological examination: any symptoms compatible with a stroke.

Laboratory Studies

 CBC. (Hb, Hct, WBCs, platelets)

 Reticulocytes count.

 LFT (bilirubin, LDH and haptoglobins).

 Peripheral blood smears. (Sickled RBCs, target cells, Howell-Jolly bodies)

 Hb electrophoresis.

 ABGs (resp. distress).

 Urinalysis (UTI).

Imaging Studies

 CXR (resp. symptoms)

 Bone radiography

 Ultrasonography

 Head CT or MRI (stroke).