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THE BEDSIDE DIAGNOSIS OF HYPOALBUMINEMIA

JAMA. 1966;195(5):384. doi:10.1001/jama.1966.03100050092029.
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Technical advances in radiology, cardiopulmonary physiology, and the clinical laboratory have at times lessened emphasis on the clinician's acumen in the refined art of physical diagnosis. However, in many instances these advances either clarify, support, or invalidate time-honored clinical signs and permit more discriminating evaluation of certain physical findings. One of these physical signs, myoedema, has in the past been empirically correlated with chronic debilitating illnesses such as pulmonary tuberculosis and neoplasia, although it has been noted in patients with myxedema. Myoedema, elicited in cachectic patients when either the deltoid, pectoralis, or biceps muscle is struck by a percussion hammer, consists of a small muscle ridge formed at the site of the stimulus. The sign has recently been resurrected, and found to correlate with the level of the serum albumin.1

A series of 72 cachectic patients, of whom 85% had demonstrable myoedema and serum albumin levels lower than 3

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