Physical examination for detection of anemia

Twelve primary health care providers in Bangladesh examined 452 pregnant women (198 had Hb < 10) for the presence or absence of pallor on nine different anatomical sites, viz. nail-beds, nail-bed blanching, palm, palmar creases, face, lips, tongue, oral mucosa and conjunctiva
Below is a table (larger version is here) of the standardized colors the researchers used and the distribution of results for the conjunctival color.

Two other studies on this topic, all with different results are PMID 2297289 and 20049324

Distribution of color of the everted lower eyelid.
1 2 3 4 5 6 7 8 9 10 11 12 13
Hb < 10 28% 42% 36%
Hb 10 – 12 19% 19% 40%
Hb > 12 10% 53% Not


Chowdhury ME, Chongsuvivatwong V, Geater AF, Akhter HH, & Winn T (2002). Taking a medical history and using a colour scale during clinical examination of pallor improves detection of anaemia. Tropical medicine & international health : TM & IH, 7 (2), 133-9 PMID: 11841703


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