Physical signs in childhood asthma

Area of Science:

• Pediatric Pulmonology
• Respiratory Medicine

Background:

• Pediatric asthma often presents with subjective symptoms and physical signs.
• Assessing the severity of airway obstruction in children with asthma is crucial for effective management.

Purpose of the Study:

• To compare subjective and physical signs of airway obstruction in children with bronchial asthma with objective pulmonary function test results.
• To identify physical examination findings that reliably correlate with the severity of airway obstruction in pediatric asthma.

Main Methods:

• Sixty-two children diagnosed with bronchial asthma were evaluated.
• Pulmonary function tests were conducted to assess airway resistance, lung volumes, and other respiratory parameters.
• Physical examination included assessment of subjective dyspnea, wheeze, rhonchi, prolonged expiration, and accessory muscle use (scalene and sternocleidomastoid contraction, supraclavicular indrawing).

Main Results:

• Pulmonary function tests revealed increased airway resistance and altered lung volumes (residual volume, functional residual capacity) in children with asthma.
• Commonly reported symptoms like dyspnea and wheeze, along with rhonchi and prolonged expiration, showed poor correlation with disease severity.
• Sternocleidomastoid contraction and supraclavicular indrawing were the only physical signs that clearly correlated with the severity of airway obstruction.

Conclusions:

• Subjective symptoms and traditional physical signs are unreliable indicators of asthma severity in children.
• Specific physical signs, namely sternocleidomastoid contraction and supraclavicular indrawing, are valuable clinical clues to the severity of airway obstruction in pediatric asthma.
• The absence of these specific signs does not rule out severe airway obstruction, necessitating objective testing.