Signs and symptoms

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Signs (including enlarged liver and spleen) and symptoms (including headache and vomiting) of acute HIV infection Symptoms of acute HIV infection.svg
Signs (including enlarged liver and spleen) and symptoms (including headache and vomiting) of acute HIV infection

Signs and symptoms are the observed or detectable signs, and experienced symptoms of an illness, injury, or condition.


Signs are objective and externally observable; symptoms are a person's reported subjective experiences. [1] 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 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. [2] [3]

Signs and symptoms


A medical sign is an objective observable indication of a disease, injury, or medical condition that may be detected during a physical examination. [4] These signs may be visible, such as a rash or bruise, or otherwise detectable such as by using a stethoscope or taking blood pressure. Medical signs, along with symptoms, help in forming a diagnosis. Some examples of signs are nail clubbing of either the fingernails or toenails, an abnormal gait, and a limbal ring a darkened ring around the iris of the eye.[ citation needed ]


A sign is different from an " indication " – the activity of a condition 'pointing to' (thus "indicating") a remedy, not the reverse (viz., it is not a remedy 'pointing to' a condition) [5] – which is a specific reason for using a particular treatment.[ clarification needed ]


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. [6] The CDC lists various diseases by their signs and symptoms such as for measles which includes a high fever, conjunctivitis, and cough, followed a few days later by the measles rash. [7]

Cardinal signs and symptoms

Cardinal signs and symptoms are 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. [8] Abnormal reflexes 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. [9] The disorder may be discovered through tests including scans. An infection may be asymptomatic which may still be transmissible. [9]


Signs and symptoms are often non-specific, but some combinations can be suggestive of certain 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. In cases where the underlying cause is known the syndrome is named as for example Down syndrome and Noonan syndrome. Other syndromes such as acute coronary syndrome may have a number of possible causes.[ citation needed ]


When a disease is evidenced by symptoms it is known as symptomatic. There are many conditions including subclinical infections 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), or then recur (relapse or recrudescence) known as a flare-up. A flare-up may show more severe symptoms. [10]

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 ] Some symptoms can be misleading as a result of referred pain, where for example a pain in the right shoulder may be due to an inflamed gallbladder and not to presumed muscle strain. [11]


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. [12] Over half of migraine episodes have a prodromal phase. [13] Schizophrenia has a notable prodromal stage, [14] as has dementia. [15]

Nonspecific symptoms

Some symptoms are specific, that is, they are associated with a single, specific medical condition.[ citation needed ]

Nonspecific symptoms, sometimes also called equivocal symptoms, [16] are not specific to a particular condition. They include unexplained weight loss, headache, pain, fatigue, loss of appetite, night sweats, and malaise. [17] 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. [18]

Other sub-types of symptoms include:

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 temperature, heart rate, breathing rate, and blood pressure. The ranges of these measurements vary with age, weight, gender and with general health. [25]

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 and atrial fibrillation. Other devices are then not needed. [26]


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").[ citation needed ]

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. [27] 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. [28] Some syndromes such as nephrotic syndrome may have a number of underlying causes that are all related to diseases that affect the kidneys. [29]

Sometimes a child or young adult may have symptoms suggestive of a genetic disorder that cannot be identified even after genetic testing. In such cases the term 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. [30]

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.[ citation needed ]

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 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. [31]

Symptoms are also grouped in to negative and positive for some mental disorders such as schizophrenia. [32]

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. [33] Examples are hallucinations, delusions, and bizarre behavior.[ citation needed ]

Negative symptoms are functions that are normally found but that are diminished or absent; for example, the negative symptoms of schizophrenia include apathy and anhedonia. [33]

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.[ citation needed ]

A majority of patients with metabolic myopathies have dynamic rather than static findings, typically experiencing exercise intolerance, muscle pain, and cramps with exercise rather than fixed weakness. [34] Those with the metabolic myopathy of McArdle's disease (GSD-V) and some individuals with 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 symptoms are present in many degenerative disorders including dementia, and Parkinson's disease. Symptoms commonly include apathy, anxiety, and depression. [35] Neurological and psychiatric symptoms are also present in some genetic disorders such as Wilson's disease. [36] Symptoms of executive dysfunction are often found in many disorders including schizophrenia, and ADHD. [37] [38]


Radiologic signs are abnormal medical findings on 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 finding. [39]


Cardinal signs and symptoms are those that may be diagnostic, and pathognomonic – of a certainty of diagnosis. Inflammation for example has a recognised group of cardinal signs and symptoms, [40] as does exacerbations of chronic bronchitis, [41] and 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 specific for a hereditary disease would rule out that disease. [42] Another example is where the vaginal pH is less than 4.5, a diagnosis of bacterial vaginosis would be excluded. [43]


A reflex is an automatic response in the body to a stimulus. [44] 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 neurons. When the response is exaggerated damage to the upper motor neurons may be indicated.[ citation needed ]


A number of medical conditions are associated with a distinctive facial expression or appearance known as a facies. [45] 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. [46]

Anamnestic signs

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. [47] :81


Some diseases including cancers, and infections may be present but show no signs or symptoms and these are known as asymptomatic. [9] A gallstone may be asymptomatic and only discovered as an incidental finding. [9] Easily spreadable viral infections such as COVID-19 may be asymptomatic but may still be transmissible. [48]



A symptom (from Greek σύμπτωμα, "accident, misfortune, that which befalls", [49] 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. [50] [51] [52] This study also includes the indications of a disease. [53] It was first described as semiotics by Henry Stubbe in 1670 a term now used for the study of sign communication.[ citation needed ]

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". [54] [55] 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". [47] :82

Development of medical testing

Painting of Rene Laennec in 1816 using an early method of auscultation on a man with tuberculosis Laennec - Theobald Chartran.jpg
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. [54] [55] [56] During the 20th century the introduction of a wide range of imaging techniques and other testing methods such as genetic testing, clinical chemistry tests, molecular diagnostics and pathogenomics have made a huge impact on diagnostic capability. [57]


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 diagnostic medical tests such as blood tests, 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. [61]


See also

Related Research Articles

<span class="mw-page-title-main">Catatonia</span> Psychiatric behavioral syndrome

Catatonia is a complex neuropsychiatric behavioral syndrome that is characterized by abnormal movements, immobility, abnormal behaviors, and withdrawal. The onset of catatonia can be acute or subtle and symptoms can wax, wane, or change during episodes. It has historically been related to schizophrenia, but catatonia is most often seen in mood disorders. It is now known that catatonic symptoms are nonspecific and may be observed in other mental, neurological, and medical conditions. Catatonia is now a stand-alone diagnosis, and the term is used to describe a feature of the underlying disorder.

<span class="mw-page-title-main">Disease</span> Condition negatively affecting an organism

A disease is a particular abnormal condition that adversely affects the structure or function of all or part of an organism and is not immediately due to any external injury. Diseases are often known to be medical conditions that are associated with specific signs and symptoms. A disease may be caused by external factors such as pathogens or by internal dysfunctions. For example, internal dysfunctions of the immune system can produce a variety of different diseases, including various forms of immunodeficiency, hypersensitivity, allergies, and autoimmune disorders.

<span class="mw-page-title-main">Genetic disorder</span> Health problem caused by one or more abnormalities in the genome

A genetic disorder is a health problem caused by one or more abnormalities in the genome. It can be caused by a mutation in a single gene (monogenic) or multiple genes (polygenic) or by a chromosomal abnormality. Although polygenic disorders are the most common, the term is mostly used when discussing disorders with a single genetic cause, either in a gene or chromosome. The mutation responsible can occur spontaneously before embryonic development, or it can be inherited from two parents who are carriers of a faulty gene or from a parent with the disorder. When the genetic disorder is inherited from one or both parents, it is also classified as a hereditary disease. Some disorders are caused by a mutation on the X chromosome and have X-linked inheritance. Very few disorders are inherited on the Y chromosome or mitochondrial DNA.

<span class="mw-page-title-main">Marfan syndrome</span> Genetic disorder involving connective tissue

Marfan syndrome (MFS) is a multi-systemic genetic disorder that affects the connective tissue. Those with the condition tend to be tall and thin, with long arms, legs, fingers, and toes. They also typically have exceptionally flexible joints and abnormally curved spines. The most serious complications involve the heart and aorta, with an increased risk of mitral valve prolapse and aortic aneurysm. The lungs, eyes, bones, and the covering of the spinal cord are also commonly affected. The severity of the symptoms is variable.

<span class="mw-page-title-main">Dementia with Lewy bodies</span> Type of progressive dementia

Dementia with Lewy bodies (DLB) is a type of dementia characterized by changes in sleep, behavior, cognition, movement, and regulation of automatic bodily functions. Memory loss is not always an early symptom. The disease worsens over time and is usually diagnosed when cognitive impairment interferes with normal daily functioning. Together with Parkinson's disease dementia, DLB is one of the two Lewy body dementias. It is a common form of dementia, but the prevalence is not known accurately and many diagnoses are missed. The disease was first described by Kenji Kosaka in 1976.

A syndrome is a set of medical signs and symptoms which are correlated with each other and often associated with a particular disease or disorder. The word derives from the Greek σύνδρομον, meaning "concurrence". When a syndrome is paired with a definite cause this becomes a disease. In some instances, a syndrome is so closely linked with a pathogenesis or cause that the words syndrome, disease, and disorder end up being used interchangeably for them. This substitution of terminology often confuses the reality and meaning of medical diagnoses. This is especially true of inherited syndromes. About one third of all phenotypes that are listed in OMIM are described as dysmorphic, which usually refers to the facial gestalt. For example, Down syndrome, Wolf–Hirschhorn syndrome, and Andersen–Tawil syndrome are disorders with known pathogeneses, so each is more than just a set of signs and symptoms, despite the syndrome nomenclature. In other instances, a syndrome is not specific to only one disease. For example, toxic shock syndrome can be caused by various toxins; another medical syndrome named as premotor syndrome can be caused by various brain lesions; and premenstrual syndrome is not a disease but simply a set of symptoms.

Encephalopathy means any disorder or disease of the brain, especially chronic degenerative conditions. In modern usage, encephalopathy does not refer to a single disease, but rather to a syndrome of overall brain dysfunction; this syndrome has many possible organic and inorganic causes.

<span class="mw-page-title-main">Asymptomatic</span> Patient is a carrier for a disease or infection but experiences no symptoms

Asymptomatic is an adjective categorising the medical conditions that patients carry but without experiencing their symptoms, despite an explicit diagnosis.

In healthcare, a differential diagnosis (DDx) is a method of analysis that distinguishes a particular disease or condition from others that present with similar clinical features. Differential diagnostic procedures are used by clinicians to diagnose the specific disease in a patient, or, at least, to consider any imminently life-threatening conditions. Often, each individual option of a possible disease is called a differential diagnosis.

<span class="mw-page-title-main">Coffin–Lowry syndrome</span> Medical condition

Coffin–Lowry syndrome is a genetic disorder that is X-linked dominant and which causes severe mental problems sometimes associated with abnormalities of growth, cardiac abnormalities, kyphoscoliosis, as well as auditory and visual abnormalities.

<span class="mw-page-title-main">Macroglossia</span> Medical condition

Macroglossia is the medical term for an unusually large tongue. Severe enlargement of the tongue can cause cosmetic and functional difficulties in speaking, eating, swallowing and sleeping. Macroglossia is uncommon, and usually occurs in children. There are many causes. Treatment depends upon the exact cause.

<span class="mw-page-title-main">Adie syndrome</span> Neurological disorder

Adie syndrome, also known as Holmes–Adie syndrome, is a neurological disorder characterized by a tonically dilated pupil that reacts slowly to light but shows a more definite response to accommodation. It is frequently seen in females with absent knee or ankle jerks and impaired sweating.

Medical model is the term coined by psychiatrist R. D. Laing in his The Politics of the Family and Other Essays (1971), for the "set of procedures in which all doctors are trained". It includes complaint, history, physical examination, ancillary tests if needed, diagnosis, treatment, and prognosis with and without treatment.

<span class="mw-page-title-main">Young–Simpson syndrome</span> Medical condition

Young–Simpson syndrome (YSS) is a rare congenital disorder with symptoms including hypothyroidism, heart defects, facial dysmorphism, cryptorchidism in males, hypotonia, intellectual disability, and postnatal growth retardation.

In medicine, a prodrome is an early sign or symptom that often indicates the onset of a disease before more diagnostically specific signs and symptoms develop. It is derived from the Greek word prodromos, meaning "running before". Prodromes may be non-specific symptoms or, in a few instances, may clearly indicate a particular disease, such as the prodromal migraine aura.

<span class="mw-page-title-main">Medical diagnosis</span> Process to identify a disease or disorder

Medical diagnosis is the process of determining which disease or condition explains a person's symptoms and signs. It is most often referred to as a diagnosis with the medical context being implicit. The information required for a diagnosis is typically collected from a history and physical examination of the person seeking medical care. Often, one or more diagnostic procedures, such as medical tests, are also done during the process. Sometimes the posthumous diagnosis is considered a kind of medical diagnosis.

<span class="mw-page-title-main">Neurological disorder</span> Any disorder of the nervous system

A neurological disorder is any disorder of the nervous system. Structural, biochemical or electrical abnormalities in the brain, spinal cord or other nerves can result in a range of symptoms. Examples of symptoms include paralysis, muscle weakness, poor coordination, loss of sensation, seizures, confusion, pain, tauopathies, and altered levels of consciousness. There are many recognized neurological disorders, some relatively common, but many rare. They may be assessed by neurological examination, and studied and treated within the specialties of neurology and clinical neuropsychology.

<span class="mw-page-title-main">Fraley syndrome</span> Medical condition

Fraley syndrome is a condition where the superior infundibulum of the upper calyx of the kidney is obstructed by the crossing renal artery branch, causing distension and dilatation of the calyx and presenting clinically as haematuria and nephralgia. Furthermore, when the renal artery obstructs the proximal collecting system, filling defects can occur anywhere in the calyces, pelvis, or ureter.

<span class="mw-page-title-main">Multiple sclerosis diagnosis</span>

Current standards for diagnosing multiple sclerosis (MS) are based on the 2018 revision of McDonald criteria. They rely on MRI detection of demyelinating lesions in the CNS, which are distributed in space (DIS) and in time (DIT). It is also a requirement that any possible known disease that produces demyelinating lesions is ruled out before applying McDonald's criteria.

Radiologically isolated syndrome (RIS) is a clinical situation in which a person has white matter lesions suggestive of multiple sclerosis (MS), as shown on an MRI scan that was done for reasons unrelated to MS symptoms. The nerve lesions in these people show dissemination in space with an otherwise normal neurological examination and without historical accounts of typical MS symptoms.


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