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Physical examination in a child or adolescent with suspected nonalcoholic fatty liver disease (NAFLD)

Physical examination in a child or adolescent with suspected nonalcoholic fatty liver disease (NAFLD)
Finding Implications
Findings associated with conditions that could lead to NAFLD
Overweight (BMI ≥85th percentile) or obese (BMI >95th percentile)  
Goiter Suggests hypothyroidism
Abnormal fat distribution Suggests partial lipodystrophy
Papilledema, neurologic deficits, short stature, and/or severe obesity Panhypopituitarism, eg, related to craniopharyngioma or its treatment
Xanthelasmata Suggests lysosomal acid lipase deficiency
Findings associated with risk of advanced NAFLD
Increased waist circumference Abdominal obesity
Acanthosis nigricans Insulin resistance, diabetes
Splenomegaly Portal hypertension
Sarcopenia (muscle wasting) Possible advanced liver disease
NAFLD: nonalcoholic fatty liver disease; BMI: body mass index.
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