Editing Signs and symptoms

{{Short description|Indications of a specific illness, including psychiatric}}
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[[File:Symptoms of acute HIV infection.svg|thumb|upright=1.3|alt=A diagram of a human torso labelled with the most common symptoms of an acute HIV infection|Signs (including [[Hepatosplenomegaly|enlarged liver and spleen]]) and symptoms (including headache and vomiting) of acute [[HIV infection]]]]

'''Signs and symptoms''' are diagnostic indications of an [[disease|illness]], injury, or condition.

Signs are objective and externally observable; symptoms are a person's reported subjective experiences.<ref>{{Cite book |last1=Sadock |first1=Benjamin J. |url=https://books.google.com/books?id=ubG51n2NgfwC&pg=PA21 |title=Kaplan & Sadock's Concise Textbook of Clinical Psychiatry |last2=Sadock |first2=Virginia A. |date=2008 |publisher=Lippincott Williams & Wilkins |isbn=978-0-7817-8746-8 |language=en |access-date=6 January 2023 |archive-date=6 January 2023 |archive-url=https://web.archive.org/web/20230106230403/https://books.google.com/books?id=ubG51n2NgfwC&pg=PA21 |url-status=live }}</ref>

A sign for example may be a higher or lower temperature than normal, raised or lowered blood pressure or an abnormality showing on a [[Medical imaging|medical scan]]. A symptom is something out of the ordinary that is experienced by an individual such as feeling feverish, a headache or other pains in the body,<ref name="CTG">{{cite web |title=Beyond Intuition: Quantifying and Understanding the Signs and Symptoms of Fever |url=https://clinicaltrials.gov/ct2/show/NCT01287143 |publisher=clinicaltrials.gov |access-date=9 January 2021 |date=5 October 2017 |archive-date=13 February 2022 |archive-url=https://web.archive.org/web/20220213213610/https://clinicaltrials.gov/ct2/show/NCT01287143 |url-status=live }}</ref><ref name="NHS">{{cite web |title=Symptoms and self-help guides by body part |url=https://www.nhsinform.scot/symptoms-and-self-help/body-parts |website=NHS inform |access-date=9 January 2021 |language=en |archive-date=13 February 2022 |archive-url=https://web.archive.org/web/20220213213620/https://www.nhsinform.scot/symptoms-and-self-help/body-parts |url-status=live }}</ref> which occur as the body's immune system fights off an infection.<ref>{{Cite web |title=How Infection Works, How Pathogens Make Us Sick — The National Academies |url=http://needtoknow.nas.edu/id/infection/how-pathogens-make-us-sick/#:~:text=White%20blood%20cells,%20antibodies,%20and,the%20infection%20from%20the%20body. |access-date=2024-11-29 |website=needtoknow.nas.edu}}</ref><ref>{{Cite web |date=June 6, 2022 |title=Infectious Diseases |url=https://my.clevelandclinic.org/health/diseases/17724-infectious-diseases |access-date=November 29, 2024 |website=Cleveland Clinic}}</ref><ref>{{Cite web |date=October 20, 2023 |title=Immune System |url=https://my.clevelandclinic.org/health/body/21196-immune-system |access-date=November 29, 2024 |website=Cleveland Clinic}}</ref>

==Signs and symptoms==
===Signs===
A medical sign is an [[Objectivity (science)|objective]] observable indication of a disease, injury, or [[medical condition]] that may be detected during a [[physical examination]].<ref name="MW2">{{cite web |title=Definition of Sign |url=https://www.merriam-webster.com/dictionary/sign |website=Merriam-Webster |date=20 June 2023 |language=en |access-date=20 January 2021 |archive-date=20 May 2006 |archive-url=https://web.archive.org/web/20060520142147/http://merriam-webster.com/dictionary/sign |url-status=live }}</ref> These signs may be visible, such as a [[rash]] or [[bruise]], or otherwise detectable such as by [[auscultation|using a stethoscope]] or taking [[blood pressure]]. Medical signs, along with [[symptom]]s, help in forming a [[Medical diagnosis|diagnosis]]. Some examples of signs are [[nail clubbing]] of either the fingernails or toenails<ref name="r465">{{cite journal | last1=Fawcett | first1=Robert S. | last2=Linford | first2=Sean | last3=Stulberg | first3=Daniel L. | title=Nail Abnormalities: Clues to Systemic Disease | journal=American Family Physician | volume=69 | issue=6 | date=2004-03-15 | pages=1417–1424 | url=https://www.aafp.org/pubs/afp/issues/2004/0315/p1417.html | access-date=2024-10-22}}</ref> or an [[abnormal gait]].<ref name="g049">{{cite journal | last1=Nonnekes | first1=Jorik | last2=Růžička | first2=Evžen | last3=Serranová | first3=Tereza | last4=Reich | first4=Stephen G. | last5=Bloem | first5=Bastiaan R. | last6=Hallett | first6=Mark | title=Functional gait disorders | journal=Neurology | publisher=Ovid Technologies (Wolters Kluwer Health) | volume=94 | issue=24 | date=2020-06-16 | issn=0028-3878 | doi=10.1212/wnl.0000000000009649 | doi-access=free | pages=1093–1099| hdl=2066/220783 | hdl-access=free }}</ref>

===Symptoms===
A symptom is something felt or experienced, such as pain or dizziness. Signs and symptoms are not mutually exclusive, for example a subjective feeling of fever can be noted as sign by using a thermometer that registers a high reading.<ref>Marie T. O'Toole, ed., ''Mosby's Medical Dictionary'', 9th ed. (St. Louis, MO: Elsevier/Mosby, 2013), Kindle loc. 154641. {{ISBN|978-0323085410}}</ref> The [[Centers for Disease Control and Prevention|CDC]] lists various diseases by their signs and symptoms such as for [[Measles#Signs and symptoms|measles]] which includes a high [[fever]], [[conjunctivitis]], and [[cough]], followed a few days later by the measles [[Maculopapular rash|rash]].<ref name="CDC1">{{cite web |title=Measles Signs and Symptoms |url=https://www.cdc.gov/measles/symptoms/signs-symptoms.html |website=Centers for Disease Control and Prevention |language=en-us |date=5 November 2020 |access-date=31 December 2020 |archive-date=11 November 2020 |archive-url=https://web.archive.org/web/20201111225954/https://www.cdc.gov/measles/symptoms/signs-symptoms.html |url-status=live }}</ref>

===Cardinal signs and symptoms===
Cardinal signs and symptoms are very specific even to the point of being [[pathognomonic]]. A cardinal sign or cardinal symptom can also refer to the major sign or symptom of a disease.<ref name="Basu">{{cite journal |last1=Basu |first1=S |last2=Sahi |first2=PK |title=Malaria: An Update. |journal=Indian Journal of Pediatrics |date=July 2017 |volume=84 |issue=7 |pages=521–528 |doi=10.1007/s12098-017-2332-2 |pmid=28357581|s2cid=11461451 }}</ref> Abnormal [[reflex]]es can indicate problems with the [[nervous system]]. Signs and symptoms are also applied to physiological states outside the context of disease, as for example when referring to the [[signs and symptoms of pregnancy]], or the symptoms of [[dehydration]]. Sometimes a disease may be present without showing any signs or symptoms when it is known as being [[asymptomatic]].<ref name="MW">{{cite web |title=Definition of Asymptomatic |url=https://www.merriam-webster.com/dictionary/asymptomatic |website=Merriam-Webster |date=26 June 2023 |language=en |access-date=2 March 2021 |archive-date=28 January 2021 |archive-url=https://web.archive.org/web/20210128141843/https://www.merriam-webster.com/dictionary/asymptomatic |url-status=live }}</ref> The disorder may be discovered through tests including scans. An [[infection]] may be asymptomatic but still be [[Transmission (medicine)|transmissible]].<ref name="MW"/>

===Syndrome===
{{main|Syndrome}}
Signs and symptoms are often non-specific, but some combinations can be suggestive of certain [[Medical diagnosis|diagnoses]], helping to narrow down what may be wrong. A particular set of characteristic signs and symptoms that may be associated with a disorder is known as a [[syndrome]].

==Related terms==
===Symptomatic===
When a disease is evidenced by symptoms it is known as '''symptomatic'''. There are many conditions including [[subclinical infection]]s that display no symptoms, and these are termed [[asymptomatic]]. 

Signs and symptoms may be mild or severe, brief or longer-lasting when they may become reduced ([[remission (medicine)|remission]]), or then recur ([[relapse]] or [[recrudescence]]) known as a [[Disease#Stages|flare-up]]. A flare-up may show more severe symptoms.<ref name="Shiel 2019">{{cite web | last=Shiel | first=William C. Jr. | title=Definition of Flare | website=MedicineNet | date=2019-06-20 | url=https://www.medicinenet.com/script/main/art.asp?articlekey=156154 | access-date=2019-12-21 | archive-date=23 January 2020 | archive-url=https://web.archive.org/web/20200123145648/https://www.medicinenet.com/script/main/art.asp?articlekey=156154 | url-status=live }}</ref>

The term [[chief complaint]], also "presenting problem", is used to describe the initial concern of an individual when seeking medical help, and once this is clearly noted a [[history of the present illness]] may be taken. The symptom that ultimately leads to a [[diagnosis]] is called a cardinal symptom.{{citation needed|date=June 2021}} Some symptoms can be misleading as a result of [[referred pain]], where for example a pain in the right shoulder may be due to [[cholecystitis|an inflamed gallbladder]] and not to presumed muscle strain.<ref name="Harrison's">Greenberger N.J., Paumgartner G (2012). Chapter 311. Diseases of the Gallbladder and Bile Ducts. In Longo D.L., Fauci A.S., Kasper D.L., Hauser S.L., Jameson J, Loscalzo J (Eds), Harrison's Principles of Internal Medicine, 18e</ref>

===Prodrome===
Many diseases have an early [[prodromal]] stage where a few signs and symptoms may suggest the presence of a disorder before further specific symptoms may emerge. [[Measles]] for example has a prodromal presentation that includes a hacking cough, fever, and [[Koplik's spots]] in the mouth.<ref name="MSD">{{cite web |title=Measles – Pediatrics |url=https://www.msdmanuals.com/en-gb/professional/pediatrics/miscellaneous-viral-infections-in-infants-and-children/measles?query=prodrome#v1022950 |website=MSD Manual Professional Edition |access-date=2 March 2021 |archive-date=12 May 2021 |archive-url=https://web.archive.org/web/20210512020436/https://www.msdmanuals.com/en-gb/professional/pediatrics/miscellaneous-viral-infections-in-infants-and-children/measles?query=prodrome#v1022950 |url-status=live }}</ref> Over half of [[migraine]] episodes have a prodromal phase.<ref name=Five2004>{{cite book| first1 = D. Joanne | last1 = Lynn | first2 = Herbert B. | last2 = Newton | first3 = Alexander | last3 = Rae-Grant |title=The 5-minute neurology consult|year=2004|publisher=Lippincott Williams & Wilkins|location=Philadelphia|isbn=978-0-683-30723-8|page=26|url=https://books.google.com/books?id=Atuv8-rVXRoC&pg=PA26|url-status=live|archive-url=https://web.archive.org/web/20170313021724/https://books.google.com/books?id=Atuv8-rVXRoC&pg=PA26|archive-date=2017-03-13}}</ref> [[Schizophrenia#Onset|Schizophrenia]] has a notable prodromal stage,<ref name=DSM5>{{cite book |title=Diagnostic and statistical manual of mental disorders : DSM-5. |date=2013 |publisher=American Psychiatric Association |location=Arlington, VA |isbn=978-0-89042-555-8 |pages=99–105 |edition=5th}}</ref> as has [[Dementia#Prodromal|dementia]].<ref name=Sherman>{{cite journal |vauthors=Sherman C, Liu CS, Herrmann N, Lanctôt KL |title=Prevalence, neurobiology, and treatments for apathy in prodromal dementia |journal=Int Psychogeriatr |volume=30 |issue=2 |pages=177–184 |date=February 2018 |pmid=28416030 |doi=10.1017/S1041610217000527 |s2cid=46788701 |url=|doi-access=free }}</ref>

===Nonspecific symptoms===
Some symptoms are ''specific'', that is, they are associated with a single, specific medical condition.{{cn|date=November 2023}}

''Nonspecific symptoms'', sometimes also called ''equivocal symptoms'',<ref>{{DorlandsDict|2=equivocal symptom}}</ref> are not specific to a particular condition. They include unexplained weight loss, headache, pain, fatigue, loss of appetite, night sweats, and [[malaise]].<ref name="concept">{{cite web |title=Constitutional symptom (Concept Id: C0009812) – MedGen – NCBI |url=https://www.ncbi.nlm.nih.gov/medgen/3593 |website=www.ncbi.nlm.nih.gov |access-date=25 March 2021 |language=en |archive-date=6 October 2022 |archive-url=https://web.archive.org/web/20221006055927/https://www.ncbi.nlm.nih.gov/medgen/3593 |url-status=live }}</ref> A group of three particular nonspecific symptoms – fever, night sweats, and weight loss – over a period of six months are termed [[B symptoms]] associated with [[lymphoma]] and indicate a poor prognosis.<ref name="ILS">{{cite web |title=Lymphoma/non-hodgkin-lymphoma/signs-and-symptoms |url=https://www.lls.org/lymphoma/non-hodgkin-lymphoma/signs-and-symptoms |website=www.lls.org |access-date=5 April 2023 |archive-date=5 April 2023 |archive-url=https://web.archive.org/web/20230405215321/https://www.lls.org/lymphoma/non-hodgkin-lymphoma/signs-and-symptoms |url-status=live }}</ref>

Other sub-types of symptoms include:
* ''constitutional'' or ''general symptoms'', which affect general well-being or the whole body, such as a fever;<ref>{{DorlandsDict|2=general symptom}}</ref><ref>{{DorlandsDict|2=constitutional symptom}}</ref>
* ''concomitant symptoms'', which are symptoms that occur at the same time as the primary symptom;<ref>{{DorlandsDict|2=concomitant symptom}}</ref>
* ''prodromal symptoms'', which are the first symptoms of an bigger set of problems;<ref>{{DorlandsDict|2=prodromal symptom}}</ref>
* ''delayed symptoms'', which happen some time after the trigger;<ref>{{DorlandsDict|2=delayed symptom}}</ref> and
* ''objective symptoms'', which are symptoms whose existence can be observed and confirmed by a healthcare provider.<ref>{{DorlandsDict|2=objective symptom}}</ref>

===Vital signs===
[[Vital signs]] are the four signs that can give an immediate measurement of the body's overall functioning and health status. They are [[body temperature|temperature]], [[heart rate]], [[breathing rate]], and [[blood pressure]]. The [[reference ranges|ranges]] of these measurements vary with age, weight, gender and with general health.<ref name="ProHealth">{{Cite web|url=https://www.prohealthsys.com/central/assessment/physical-assessment/vital-signs/vital_signs_table/|title=Vital Signs Table – Prohealthsys|date=3 July 2013|access-date=27 December 2021|archive-date=27 December 2021|archive-url=https://web.archive.org/web/20211227194342/https://www.prohealthsys.com/central/assessment/physical-assessment/vital-signs/vital_signs_table/|url-status=live}}</ref>

A digital application has been developed for use in clinical settings that measures three of the vital signs (not temperature) using just a [[smartphone]], and has been approved by [[NHS England]]. The application is registered as ''Lifelight First'', and ''Lifelight Home'' is under development (2020) for monitoring-use by people at home using just the camera on their smartphone or tablet. This will additionally measure [[Oxygen saturation (medicine)|oxygen saturation]] and [[atrial fibrillation]]. Other devices are then not needed.<ref name="AI">{{cite web |title=Solution |url=https://lifelight.ai/solution/ |website=Lifelight |access-date=2 February 2021 |archive-date=19 January 2021 |archive-url=https://web.archive.org/web/20210119170207/https://lifelight.ai/solution/ |url-status=live }}</ref>

===Syndromes===
{{Further|List of syndromes|List of medical triads, tetrads, and pentads}}
Many conditions are indicated by a group of known signs, or signs and symptoms. These can be a group of three known as a triad; a group of four ("tetrad"); or a group of five ("pentad").{{cn|date=November 2023}}

An example of a triad is [[Meltzer's triad]] presenting [[purpura]] a rash, [[arthralgia]] painful joints, and [[myalgia]] painful and weak muscles. Meltzer's triad indicates the condition [[cryoglobulinemia]]. [[Huntington's disease]] is a [[neurodegenerative disease]] that is characterized by a triad of motor, cognitive, and psychiatric signs and symptoms.<ref name=Jensen>{{cite journal |vauthors=Jensen RN, Bolwig T, Sørensen SA |title=[Psychiatric symptoms in patients with Huntington's disease] |language=da |journal=Ugeskr Laeger |volume=180 |issue=13 |date=March 2018 |pmid=29587954 }}</ref> A large number of these groups that can be characteristic of a particular disease are known as a [[syndrome]]. [[Noonan syndrome]] for example, has a diagnostic set of unique facial and musculoskeletal features.<ref name="Genetics">{{cite web |title=Noonan syndrome: MedlinePlus Genetics |url=https://medlineplus.gov/genetics/condition/noonan-syndrome/ |website=medlineplus.gov |access-date=2 February 2021 |language=en |archive-date=27 January 2021 |archive-url=https://web.archive.org/web/20210127044811/https://medlineplus.gov/genetics/condition/noonan-syndrome/ |url-status=live }}</ref> Some syndromes such as [[nephrotic syndrome]] may have a number of underlying causes that are all related to diseases that affect the [[kidney]]s.<ref name="NIDDK">{{cite web |title=Nephrotic Syndrome in Adults {{!}} NIDDK |url=https://www.niddk.nih.gov/health-information/kidney-disease/nephrotic-syndrome-adults |website=National Institute of Diabetes and Digestive and Kidney Diseases |access-date=3 March 2021 |archive-date=9 January 2020 |archive-url=https://web.archive.org/web/20200109055457/https://www.niddk.nih.gov/health-information/kidney-disease/nephrotic-syndrome-adults |url-status=live }}</ref>

Sometimes a child or young adult may have symptoms suggestive of a [[genetic disorder]] that cannot be [[diagnosis|identified]] even after [[genetic testing]]. In such cases the term [[Syndrome without a name|SWAN]] (syndrome without a name) may be used. Often a diagnosis may be made at some future point when other more specific symptoms emerge but many cases may remain undiagnosed. The inability to diagnose may be due to a unique combination of symptoms or an overlap of conditions, or to the symptoms being atypical of a known disorder, or to the disorder being extremely rare.<ref name="swan">{{cite web |title=What does SWAN or being undiagnosed mean? {{!}} SWAN UK |url=https://www.undiagnosed.org.uk/support-information/what-does-swan-or-being-undiagnosed-mean/ |website=www.undiagnosed.org.uk |date=22 March 2017 |access-date=3 March 2021 |archive-date=12 June 2021 |archive-url=https://web.archive.org/web/20210612112557/https://www.undiagnosed.org.uk/support-information/what-does-swan-or-being-undiagnosed-mean/ |url-status=live }}</ref>

It is possible that a person with a particular syndrome might not display every single one of the signs and/or symptoms that compose/define a syndrome.{{cn|date=February 2024}}

===Positive and negative===
Sensory symptoms can also be described as '''positive symptoms''', or as '''negative symptoms''' depending on whether the symptom is abnormally present such as tingling or itchiness, or abnormally absent such as [[Anosmia|loss of smell]]. The following terms are used for negative symptoms – [[hypoesthesia]] is a partial loss of sensitivity to moderate stimuli, such as pressure, touch, warmth, cold. [[Anesthesia]] is the complete loss of sensitivity to stronger stimuli, such as pinprick. [[Hypoalgesia]]  (analgesia) is loss of sensation to painful stimuli.<ref>''Harrison's Principles of Internal Medicine'', 19th edition, [https://accessmedicine.mhmedical.com/content.aspx?bookid=1130&sectionid=79724797 Chapter 31: Numbness, Tingling, and Sensory Loss] {{Webarchive|url=https://web.archive.org/web/20210111170630/https://accessmedicine.mhmedical.com/content.aspx?bookid=1130&sectionid=79724797 |date=11 January 2021 }}</ref>

Symptoms are also grouped in to negative and positive for some [[mental disorder]]s such as [[schizophrenia]].<ref name="SGG">{{cite web |url=http://www.surgeongeneral.gov/library/mentalhealth/chapter2/sec2.html |title=Mental Health: a Report from the Surgeon General |publisher=Surgeongeneral.gov |access-date=2011-12-17 |url-status=live |archive-url=https://web.archive.org/web/20120111043025/http://www.surgeongeneral.gov/library/mentalhealth/chapter2/sec2.html |archive-date=2012-01-11 |year=1999 }}</ref> [[Schizophrenia#Positive symptoms|Positive symptoms]] are those that are present in the disorder and are not normally experienced by most individuals and reflects an excess or distortion of normal functions;<ref name="Understanding Psychosis Fact Sheet">[http://www.mifa.org.au/sites/www.mifa.org.au/files/documents/164819%20Understanding%20Psychosis.pdf Understanding Psychosis] {{webarchive|url=https://web.archive.org/web/20121225041115/http://www.mifa.org.au/sites/www.mifa.org.au/files/documents/164819%20Understanding%20Psychosis.pdf |date=2012-12-25 }}, Mental Health Illness of Australia.</ref> examples are [[hallucinations]], [[delusions]], and bizarre behavior.{{cn|date=November 2023}} [[Schizophrenia#Negative symptoms|Negative symptoms]] are functions that are normally found but that are diminished or absent,  such as [[apathy]] and [[anhedonia]].<ref name="Understanding Psychosis Fact Sheet" />

=== Dynamic and static ===
Dynamic symptoms are capable of change depending on circumstance, whereas static symptoms are fixed or unchanging regardless of circumstance. For example, the symptoms of [[exercise intolerance]] are dynamic as they are brought on by exercise, but alleviate during rest. Fixed [[muscle weakness]] is a static symptom as the muscle will be weak regardless of exercise or rest.{{cn|date=February 2024}}

A majority of patients with [[Metabolic myopathy|metabolic myopathies]] have dynamic rather than static findings, typically experiencing exercise intolerance, muscle pain, and cramps with exercise rather than fixed weakness.<ref>{{Cite journal |last1=Darras |first1=Basil T. |last2=Friedman |first2=Neil R. |date=2000-02-01 |title=Metabolic myopathies: a clinical approach; part I |url=https://www.pedneur.com/article/S0887-8994(99)00133-2/fulltext |journal=Pediatric Neurology |language=English |volume=22 |issue=2 |pages=87–97 |doi=10.1016/S0887-8994(99)00133-2 |issn=0887-8994 |pmid=10738913 |access-date=3 April 2023 |archive-date=3 April 2023 |archive-url=https://web.archive.org/web/20230403183821/https://www.pedneur.com/article/S0887-8994(99)00133-2/fulltext |url-status=live |url-access=subscription }}</ref> Those with the metabolic myopathy of [[Glycogen storage disease type V|McArdle's disease (GSD-V)]] and some individuals with [[Phosphoglucomutase#Disease relevance|phosphoglucomutase deficiency (CDG1T/GSD-XIV)]], initially experience exercise intolerance during mild-moderate aerobic exercise, but the symptoms alleviate after 6–10 minutes in what is known as "[[second wind]]".

===Neuropsychiatric===
Neuropsychiatric symptoms are present in many [[degenerative disorder]]s including [[dementia]], and [[Parkinson's disease]]. Symptoms commonly include [[apathy]], [[anxiety]], and [[depression (mood)|depression]].<ref name="Mueller">{{cite journal |last1=Mueller |first1=C |last2=Rajkumar |first2=AP |last3=Wan |first3=YM |last4=Velayudhan |first4=L |last5=Ffytche |first5=D |last6=Chaudhuri |first6=KR |last7=Aarsland |first7=D |title=Assessment and Management of Neuropsychiatric Symptoms in Parkinson's Disease. |journal=CNS Drugs |date=July 2018 |volume=32 |issue=7 |pages=621–635 |doi=10.1007/s40263-018-0540-6 |pmid=30027401 |s2cid=51701905 |url=https://kclpure.kcl.ac.uk/portal/en/publications/assessment-and-management-of-neuropsychiatric-symptoms-in-parkinsons-disease(c3ea68a7-ca1d-4274-9f49-40e68422fb97).html |access-date=26 March 2021 |archive-date=3 December 2020 |archive-url=https://web.archive.org/web/20201203205443/https://kclpure.kcl.ac.uk/portal/en/publications/assessment-and-management-of-neuropsychiatric-symptoms-in-parkinsons-disease(c3ea68a7-ca1d-4274-9f49-40e68422fb97).html |url-status=live }}</ref> [[Wilson's disease#Neuropsychiatric symptoms|Neurological and psychiatric symptoms]] are also present in some [[genetic disorder]]s such as [[Wilson's disease]].<ref name="NIDDK1">{{cite web |title=Symptoms & Causes {{!}} NIDDK |url=https://www.niddk.nih.gov/health-information/liver-disease/wilson-disease/symptoms-causes |website=National Institute of Diabetes and Digestive and Kidney Diseases |access-date=10 March 2021 |archive-date=9 October 2019 |archive-url=https://web.archive.org/web/20191009015938/https://www.niddk.nih.gov/health-information/liver-disease/wilson-disease/symptoms-causes |url-status=live }}</ref> Symptoms of [[executive dysfunction]] are often found in many disorders including [[schizophrenia]], and [[ADHD]].<ref name="Lesh">{{cite journal | vauthors = Lesh TA, Niendam TA, Minzenberg MJ, Carter CS | title = Cognitive control deficits in schizophrenia: mechanisms and meaning |journal=Neuropsychopharmacology | volume = 36 | issue = 1 | pages = 316–338 | date = January 2011 | pmid = 20844478 |pmc = 3052853 |doi =10.1038/npp.2010.156 }}</ref><ref name="Brown">{{cite journal |vauthors=Brown TE |title=ADD/ADHD and Impaired Executive Function in Clinical Practice |journal=Current Psychiatry Reports |volume=10 |issue=5 |pages=407–411 |date=October 2008 |pmid=18803914 |doi=10.1007/s11920-008-0065-7 |s2cid=146463279 }}</ref>

===Radiologic===
[[Radiologic sign]]s are abnormal [[medical findings]] on [[Medical imaging|imaging scanning]]. These include the [[Mickey Mouse sign]] and the [[Golden S sign]]. When using imaging to find the cause of a complaint, another unrelated finding may be found known as an [[incidental imaging finding|incidental finding]].<ref name=BMJ18>{{cite journal |last1=O'Sullivan |first1=JW |last2=Muntinga |first2=T |last3=Grigg |first3=S |last4=Ioannidis |first4=JPA |title=Prevalence and outcomes of incidental imaging findings: umbrella review. |journal=BMJ |date=18 June 2018 |volume=361 |pages=k2387 |doi=10.1136/bmj.k2387 |pmid=29914908|pmc=6283350 }}</ref>

===Cardinal===
Cardinal signs and symptoms are those that may be diagnostic, and [[pathognomonic]] – of a certainty of diagnosis. [[Inflammation#Cardinal signs|Inflammation]] for example has a recognised group of cardinal signs and symptoms,<ref name="Freire">{{cite journal |last1=Freire |first1=MO |last2=Van Dyke |first2=TE |title=Natural resolution of inflammation. |journal=Periodontology 2000 |date=October 2013 |volume=63 |issue=1 |pages=149–64 |doi=10.1111/prd.12034 |pmid=23931059|pmc=4022040 }}</ref> as does [[Bronchitis#Chronic bronchitis|exacerbations of chronic bronchitis]],<ref>{{Cite web |url=http://www.bsac.org.uk/pyxis/RTI/Chronic%20bronchitis/Chronic%20bronchitis.htm |title=Acute exacerbations of chronic bronchitis |access-date=31 December 2020 |archive-date=6 April 2006 |archive-url=https://web.archive.org/web/20060406154131/http://www.bsac.org.uk/pyxis/RTI/Chronic%20bronchitis/Chronic%20bronchitis.htm |url-status=dead }}</ref> and [[Signs and symptoms of Parkinson's disease#Cardinal signs|Parkinson's disease]].

In contrast to a pathognomonic cardinal sign, the absence of a sign or symptom can often rule out a condition. This is known by the Latin term ''[[sine qua non]]''. For example, the absence of known genetic mutations [[Sensitivity and specificity|specific]] for a [[hereditary disease]] would rule out that disease.<ref name="Lynch">{{cite journal |vauthors=Lynch HT, Lynch JF, Lynch PM, Attard T |title=Hereditary colorectal cancer syndromes: molecular genetics, genetic counseling, diagnosis and management |journal=Fam Cancer |volume=7 |issue=1 |pages=27–39 |date=2008 |pmid=17999161 |doi=10.1007/s10689-007-9165-5 |s2cid=20103607 |url=}}</ref> Another example is where the [[Vagina#Infections, diseases, and safe sex|vaginal pH]] is less than 4.5, a diagnosis of [[bacterial vaginosis]] would be excluded.<ref name="Manka">{{cite journal |vauthors=Mańka W, Adrianowicz L, Wesołek Z, Adrianowicz K |title=[The value of determining vaginal secretion reaction (pH) as a screening test of bacterial vaginosis] |language=Polish |journal=Wiad Lek |volume=55 |issue=1–2 |pages=51–5 |date=2002 |pmid=12043316 |doi= |url=}}</ref>

===Reflexes===
A [[reflex]] is an automatic response in the body to a stimulus.<ref name=M-W>{{cite web|title=Definition of REFLEX|url=https://www.merriam-webster.com/dictionary/reflex|website=Merriam-Webster|date=30 June 2023|language=en|access-date=4 February 2021|archive-date=8 February 2021|archive-url=https://web.archive.org/web/20210208214027/https://www.merriam-webster.com/dictionary/reflex|url-status=live}}</ref> Its absence, reduced (hypoactive), or exaggerated (hyperactive) response can be a sign of damage to the [[central nervous system]] or [[peripheral nervous system]]. In the [[patellar reflex]] (knee-jerk) for example, its reduction or absence is known as [[Westphal's sign]] and may indicate damage to [[lower motor neuron lesion|lower motor neurons]]. When the response is exaggerated damage to the [[upper motor neuron lesion|upper motor neurons]] may be indicated.{{citation needed|date=June 2021}}

===Facies===
A number of [[medical condition]]s are associated with a distinctive facial expression or appearance known as a [[Facies (medical)|facies]].<ref name="M-W2">{{cite web |title=Definition of FACIES |url=https://www.merriam-webster.com/dictionary/facies |website=Merriam-Webster |access-date=4 February 2021 |language=en |archive-date=10 February 2021 |archive-url=https://web.archive.org/web/20210210132817/https://www.merriam-webster.com/dictionary/facies |url-status=live }}</ref> An example is [[elfin facies]] which has facial features like those of the [[elf]], and this may be associated with [[Williams syndrome]], or [[Donohue syndrome]]. The most well-known facies is probably the [[Hippocratic facies]] that is seen on a person as they near death.<ref name="Chadwick 1978">{{cite book |translator-last1=Chadwick |translator-first1=J. |translator-last2=Mann |translator-first2=W.N. |title=Hippocratic writings |publisher=Penguin |location=Harmondsworth, UK |year=1978 |pages=[https://archive.org/details/hippocraticwriti0000hipp/page/170 170–71] |isbn=0-14-044451-3 |url=https://archive.org/details/hippocraticwriti0000hipp/page/170 }}</ref>

===Anamnestic signs===
[[Medical history|Anamnestic signs]] (from ''anamnēstikós'', ἀναμνηστικός, "able to recall to mind") are signs that indicate a past condition, for example paralysis in an arm may indicate a past [[stroke]].<ref name="King 1982">{{Cite book |author=King, Lester S. |author-link=Lester S. King|title=Medical Thinking: A Historical Preface |publisher=Princeton University Press |location=Princeton, NJ |year=1982 |isbn=0-691-08297-9}}</ref>{{rp|81}}

===Asymptomatic===
Some diseases including [[cancer]]s, and infections may be present but show no signs or symptoms
and these are known as [[asymptomatic]].<ref name="MW"/> A gallstone may be asymptomatic and only discovered as an [[incidental finding]].<ref name="MW"/> Easily spreadable viral infections such as [[COVID-19]] may be asymptomatic but may still be [[Transmission (medicine)|transmissible]].<ref name="Lancet">{{cite journal |display-authors=et al|last1=Sayampanathan |first1=Andrew A. |last2=Heng |first2=Cheryl S. |last3=Pin |title=Infectivity of asymptomatic versus symptomatic COVID-19 |journal=The Lancet |pages=93–94 |language=English |doi=10.1016/S0140-6736(20)32651-9 |date=9 January 2021|volume=397 |issue=10269 |pmid=33347812 |pmc=7836843 }}</ref>

==History==
===Symptomatology===
A symptom (from [[Greek language|Greek]] σύμπτωμα, "accident, misfortune, that which befalls",<ref>{{cite web |url=https://www.perseus.tufts.edu/cgi-bin/ptext?doc=Perseus%3Atext%3A1999.04.0057%3Aentry%3D%2398870 |title=Sumptoma, Henry George Liddell, Robert Scott, ''A Greek-English Lexicon'', at Pursues |publisher=Perseus.tufts.edu |access-date=2011-12-17 |archive-date=1 February 2009 |archive-url=https://web.archive.org/web/20090201104133/http://www.perseus.tufts.edu/cgi-bin/ptext?doc=Perseus%3Atext%3A1999.04.0057%3Aentry%3D%2398870 |url-status=live }}</ref> from συμπίπτω, "I befall", from συν- "together, with" and πίπτω, "I fall") is a departure from normal function or feeling. Symptomatology (also called semiology) is a branch of [[medicine]] dealing with the signs and symptoms of a disease.<ref name="BMA">{{cite book |author=The British Medical Association (BMA) |date=2002 |title=Illustrated Medical Dictionary |publisher=A Dorling Kindersley Book |page=406 |isbn=978-0-7513-3383-1}}</ref><ref name="MW1">{{cite web |title=Definition of SYMPTOMATOLOGY |url=https://www.merriam-webster.com/dictionary/symptomatology |website=Merriam-Webster |access-date=9 January 2021 |language=en |archive-date=11 January 2021 |archive-url=https://web.archive.org/web/20210111071932/https://www.merriam-webster.com/dictionary/symptomatology |url-status=live }}</ref><ref name="MW3">{{cite web |title=Definition of SEMIOLOGY |url=https://www.merriam-webster.com/dictionary/semiology |website=Merriam-Webster |access-date=9 January 2021 |language=en |archive-date=11 January 2021 |archive-url=https://web.archive.org/web/20210111074412/https://www.merriam-webster.com/dictionary/semiology |url-status=live }}</ref> This study also includes the [[Indication (medicine)|indications]] of a [[disease]].<ref>{{cite book |author=David A. Bedworth, Albert E. Bedworth |title=The Dictionary of Health Education |url=https://books.google.com/books?id=SihnDAAAQBAJ&pg=PA484 |year=2010 |publisher=Oxford University Press |isbn=978-0-19-534259-8 |pages=484 |url-status=live |archive-url=https://web.archive.org/web/20180509174430/https://books.google.com/books?id=SihnDAAAQBAJ&pg=PA484 |archive-date=2018-05-09 }}</ref> It was first described as [[semiotics]] by [[Henry Stubbe]] in 1670 a term now used for the study of [[semiosis|sign communication]].{{citation needed|date=June 2021}}

Prior to the nineteenth century there was little difference in the powers of observation between physician and patient. Most medical practice was conducted as a co-operative interaction between the physician and patient; this was gradually replaced by a "monolithic consensus of opinion imposed from within the community of medical investigators".<ref name="Jewson 1974">Jewson, N.D., "[http://soc.sagepub.com/cgi/content/abstract/8/3/369 Medical Knowledge and the Patronage System in 18th Century England] {{Webarchive|url=https://web.archive.org/web/20090307093521/http://soc.sagepub.com/cgi/content/abstract/8/3/369 |date=7 March 2009 }}", ''Sociology'', Vol. 8, No. 3 (1974), pp. 369–85.</ref><ref name="Jewson 1976">Jewson, N.D., "[http://soc.sagepub.com/cgi/content/abstract/10/2/225 The Disappearance of the Sick Man from Medical Cosmology, 1770–1870] {{Webarchive|url=https://web.archive.org/web/20090316085219/http://soc.sagepub.com/cgi/content/abstract/10/2/225 |date=16 March 2009 }}", ''Sociology'', Vol. 10, No. 2, (1976), pp. 225–44.</ref> Whilst each noticed much the same things, the physician had a more informed interpretation of those things: "the physicians knew what the findings meant and the layman did not".<ref name="King 1982" />{{rp|82}}

===Development of medical testing===
{{Further|Medical test}}
[[File:Laennec - Théobald Chartran.jpg|thumb|Painting of [[René Laennec]] in 1816 using an early method of [[auscultation]] on a man with [[tuberculosis]]]]
A number of advances introduced mostly in the 19th century, allowed for more objective assessment by the physician in search of a diagnosis, and less need of input from the patient.<ref name="Jewson 1974" /><ref name="Jewson 1976" /><ref name="pmid3413276">{{cite journal |author=Tsouyopoulos N |title=The mind-body problem in medicine (the crisis of medical anthropology and its historical preconditions) |journal=Hist Philos Life Sci |volume=10 Suppl |pages=55–74 |year=1988 |pmid=3413276 }}</ref> During the 20th century the introduction of a wide range of [[medical imaging|imaging techniques]] and other testing methods such as [[genetic testing]], [[Clinical chemistry#Tests|clinical chemistry tests]], [[molecular diagnostics]] and [[pathogenomics]] have made a huge impact on diagnostic capability.<ref name = "Demuth">{{cite journal | vauthors = Demuth A, Aharonowitz Y, Bachmann TT, Blum-Oehler G, Buchrieser C, Covacci A, Dobrindt U, Emödy L, van der Ende A, Ewbank J, Fernández LA, Frosch M, García-Del Portillo F, Gilmore MS, Glaser P, Goebel W, Hasnain SE, Heesemann J, Islam K, Korhonen T, Maiden M, Meyer TF, Montecucco C, Oswald E, Parkhill J, Pucciarelli MG, Ron E, Svanborg C, Uhlin BE, Wai SN, Wehland J, Hacker J | title = Pathogenomics: an updated European Research Agenda | journal = Infection, Genetics and Evolution | volume = 8 | issue = 3 | pages = 386–93 | date = May 2008 | pmid = 18321793 | doi = 10.1016/j.meegid.2008.01.005 | publication-date = May 2008 | hdl = 10033/30395 | hdl-access = free }}</ref>
* In 1761 the [[percussion (medicine)|percussion]] technique for diagnosing respiratory conditions was discovered by [[Leopold Auenbrugger]].<ref name=Bedford>{{cite journal |vauthors=Bedford DE |title=Auenbrugger's contribution to cardiology. History of percussion of the heart |journal=Br Heart J |volume=33 |issue=6 |pages=817–21 |date=November 1971 |pmid=4256273 |pmc=458433 |doi=10.1136/hrt.33.6.817 |url=}}</ref> This method of tapping body cavities to note any abnormal sounds had already been in practice for a long time in cardiology.<ref name=Bedford/> Percussion of the thorax became more widely known after 1808 with the translation of Auenbrugger's work from Latin into French by [[Jean-Nicolas Corvisart]].<ref name="Bynum">{{Cite book|title=Science and the Practice of Medicine in the Nineteenth Century|last=Bynum|first=W.F.|publisher=Cambridge University Press|year=1994|isbn=978-0-521-27205-6|location=New York|pages=35–36}}</ref>
* In 1819 the introduction of the [[stethoscope]] by [[René Laennec]] began to replace the centuries-old technique of immediate [[auscultation]] – listening to the heart by placing the ear directly on the chest, with mediate auscultation using the stethoscope to listen to the sounds of the heart and respiratory tract. Laennec's publication was translated into English, 1824, by [[John Forbes (physician)#Publications|John Forbes]].
* The 1846 introduction by surgeon [[John Hutchinson (surgeon)|John Hutchinson]] (1811–1861) of the [[spirometer]], an apparatus for assessing the mechanical properties of the lungs via measurements of forced exhalation and forced inhalation. (The recorded [[lung volumes]] and air flow rates are used to [[Spirometry|distinguish between]] restrictive disease (in which the lung volumes are decreased: e.g., [[cystic fibrosis]]) and obstructive diseases (in which the lung volume is normal but the air flow rate is impeded; e.g., [[Pneumatosis#Lungs|emphysema]]).){{citation needed|date=June 2021}}
* The 1851 invention by [[Hermann von Helmholtz]] (1821–1894) of the [[ophthalmoscope]], which allowed physicians to examine the inside of the human eye.
* The ({{circa|1870}}) immediate widespread clinical use of [[Clifford Allbutt|Sir Thomas Clifford Allbutt's]] (1836–1925) six-inch (rather than twelve-inch) pocket [[Medical thermometer|clinical thermometer]], which he had devised in 1867.<ref>Allbutt, T.C., "Medical Thermometry", British and Foreign Medico-Chirurgical Review, [https://archive.org/stream/britishforeignme45londuoft#page/428/mode/2up Vol. 45, No. 90, (April 1870), pp. 429–41]; [https://archive.org/stream/britishforeignme46londuoft#page/144/mode/2up Vol. 46, No. 91, (July 1870), pp. 144–56.]</ref>
* The 1882 introduction of bacterial cultures by [[Robert Koch]], initially for [[tuberculosis]], being the first laboratory test to confirm bacterial infections.
* The 1895 clinical use of [[X-ray]]s which began almost immediately after they had been discovered that year by [[Wilhelm Conrad Röntgen]] (1845–1923).
* The 1896 introduction of the [[sphygmomanometer]], designed by [[Scipione Riva-Rocci]] (1863–1937), to measure [[blood pressure]].

==Diagnosis==
The recognition of signs, and noting of symptoms may lead to a diagnosis. Otherwise a [[physical examination]] may be carried out, and a [[medical history]] taken. Further [[Medical test#Diagnostic|diagnostic medical tests]] such as [[blood test]]s, [[medical imaging|scans]], and [[biopsies]], may be needed.  An [[X-ray]] for example would soon be diagnostic of a suspected [[bone fracture]]. A noted significance detected during an examination or from a medical test may be known as a [[medical finding]].<ref name="Free">{{cite web |title=finding |url=https://medical-dictionary.thefreedictionary.com/finding |website=The Free Dictionary |access-date=1 March 2021 |archive-date=15 May 2021 |archive-url=https://web.archive.org/web/20210515152407/https://medical-dictionary.thefreedictionary.com/finding |url-status=live }}</ref>

==Examples==
{{See also|List of eponymous medical signs}}
{{Further|List of medical symptoms#Medical signs and symptoms}}
{{div col|colwidth=35em}}
* [[Ascites]] (build-up of fluid in the abdomen)
* [[Nail clubbing]] (deformed nails)
* [[Cough]]
* [[Death rattle]] (last moments of life)
* [[Hemoptysis]] (blood-stained sputum)
* [[Jaundice]]
* [[Organomegaly]] an enlarged organ such as the [[liver]] ([[hepatomegaly]])
* [[Palmar erythema]] (reddening of hands)
* [[Hypersalivation]] excessive (saliva)
* [[Weight loss#Unintentional|Unintentional weight loss]]
{{div col end}}

==See also==
{{Portal|Medicine}}
* {{annotated link|Biomarker (medicine)}}
* {{annotated link|Focal neurologic signs}}

==References==
{{reflist|2}}{{Commons}}{{Medical terms to describe disease conditions}}
{{Symptoms and signs}}
{{Authority control}}

{{Use dmy dates|date=April 2017}}

[[Category:Medical signs| ]]
[[Category:Symptoms| ]]