PHYSICAL EXAMINATION FINDINGS IN FIBROMUSCULAR DYSPLASIA: A REPORT OF THE UNITED STATES REGISTRY FOR FIBROMUSCULAR DYSPLASIA

Results: Mean age at the time of enrollment was 55.7 +13.1 years (range 18-86 years) and 91% of pts were female. Mean BMI was 25.5 + 5.2 kg/ m2 and 48.8% of patients had a BMI > 25 kg/m2. Mean blood pressure on enrollment was 130/75 + 20/12.4 mmHg and 77.9% of pts were taking at least one blood pressure medication. 60% of pts reported significant headaches and 27.5% had pulsatile tinnitus. A cervical or epigastric bruit was a presenting sign that led to FMD diagnosis in 22.2% and 9.4% of pts, respectively. A neurological and vascular PE was recorded at the time of enrollment in 92.6% (414/447). Findings suggestive of Horner’s syndrome (pupil abnormality or ptosis) were reported in 12.4% of pts. Cranial nerve abnormalities were reported in 9.4% and other focal neurological deficits were reported in 13.6%. Bruits were reported over the carotid arteries (30.5%; 18.1% bilateral), epigastrium (17.5%), and flanks (6.1%; 3.2% bilateral). Among pts with reported imaging of the extracranial circulation (carotid and vertebral) and a documented PE, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of carotid bruit in predicting extracranial carotid FMD were 45.4%, 93.7%, 95.4%, and 37.4%, respectively. The sensitivity, specificity, PPV and NPV of epigastric and/or flank bruit in predicting renal and/or mesenteric FMD were 24.0%, 93.3%, 92.6%, and 26.0%, respectively.