A 'Head to toe' Review of Liver Disease Findings

There are many findings that suggest that a patient has liver disease that are outside of the liver/abdomen itself. Here is a 'head-to-toe' approach to remembering 19 of the findings:

1. Three 'head' signs: temporal wasting, fetor hepaticus, hepatic encephalopathy
2. Seven 'hand' signs: palmar erythema, clubbing, terry’s nails, leukonychia, thenar wasting, asterixis, Duputren’s contracture
3. Four signs of increased estrogen: gynecomastia, testicular atrophy, frontal balding, spider nevi
4. Three peripheral signs: jaundice, easy bruising/petechiae, pitting edema
5. Other: ascites, enlarged liver

*Note: there are many other findings that are suggestive of liver disease that are not included in the above list.

Let us know what your approach to recognizing liver disease findings is!

References: 

1. Cirrhosis and Chronic Liver Failure: Part I. Diagnosis and Evaluation. American Family Physician. https://www.aafp.org/afp/2006/0901/p756.html

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