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Clinical signs of a disease: definition, examples

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The clinical signs of a disease include symptoms and physical signs (objective signs presented by the patient and found by examining him). These will make it possible to make a diagnosis and to confirm it if necessary by additional examinations.

Definition: what does clinical signs mean?

The clinical signs correspond to two elements: on the one hand symptoms that are subjectivethat correspond to the signs reported by the patient during the anamnesis” (the questioning of the patient) and on the other side physical signswhich are objective signs, “what the doctor will objectively observe when examining the patient“. This whole set is part of the clinical signs.”The symptom may be shortness of breath, pain, fatigue… and the clinically observable physical signs may be a variation in blood pressure (hyper- or hypotension), a lack of oxygen in the blood, a change in the color of a limb For example“, specifies Pr Nicolas Noel, internal medicine of the hospital Bicêtre and the faculty of medicine of the university Paris-Saclay.

What is a positive clinical sign?

When the doctor carries out a diagnostic investigation: he takes into account the symptoms (subjective signs) and physical signs (objective signs). All these symptoms will then be grouped into syndromes. “I’m tired, my skin is pale, I’m out of breath. These signs may correspond to a syndrome: the anemic syndrome, and suggest a diagnosis of anemia, a lack of red blood cells“, he notes. The positive clinical signs are therefore lare the signs that the patient will present.

What is a negative clinical sign?

Beyond the positive signs, presented by the patient, we will wonder if these can correspond to another syndrome. The doctor will then look for negative clinical signs, which rule out another cause. “The same symptoms can indeed refer to something else. Fatigue, pale skin, shortness of breath can be a lung infection. If there is no fever, it does not refer to this infection. The negative sign is therefore the lack of fever“, explains Professor Noel. In all diagnostic procedures, we think in tables: the positive signs are therefore the concordant signs to evoke a main diagnosis and differential diagnoses. The search for negative signs rule out differential diagnoses. Complementary examinations will confirm these signs.

What is the difference between clinical signs and symptoms?

Each symptom and each clinical sign forms the pieces of the “diagnostic puzzle”. “In these rooms you have symptoms, what the patient is complaining about and the physical signs, what the doctor observes or what the patient can observe if he has palpated, for example, a ball“. Syndromes are groupings of puzzle pieces that come together.”With them, a diagnosis begins to emerge: the association of several symptoms with one or more physical signs is a syndrome and the key to a diagnosis.

Behind a symptom such as pain, there are not always observable physical signs.

What is the difference between clinical and paraclinical sign?

THE paraclinical signs correspond to complementary examinations while the clinical signs are those observed during the examination of the patient by the doctor. The paraclinical signs come after the clinical signs. They can be a biological examination (blood test or fluid analysis), imaging (radiology, ultrasound, scanner, MRI, etc.), biopsies, fibroscopy or colonoscopy. “The paraclinic is triggered when confirmation is needed of the diagnosis. It is the extension of the clinic. It is customary to say that the anamnesis is 90% of the orientation on the first symptoms presented by a patient, the clinical examination 7% and the paraclinical examinations 2-3%. There is therefore no systematic need for additional examinations to establish the diagnosis.“, concludes Professor Noel.

Examples of clinical signs

The objective clinical signs are:

  • A breath cardiac;
  • a tachycardiathe acceleration of the measured heart rate;
  • a sizea palpable ganglion;
  • A large liver;
  • jaundice (“jaundice”)…

We can have patients who have pain and who do not understand that we cannot move forward on the origin of this pain. Behind a symptom such as pain, there are not always observable physical signs. On the other hand, if there is a deformation, a swelling of the joints, these physical signs will make it possible to advance towards etiologies, causes to be able to advance“, he concludes.

Thanks to Pr Nicolas Noel, internal medicine department of Bicêtre hospital (AP-HP), faculty of medicine of Paris-Saclay University.

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