Physical examination maneuver

Physical Exam

Pallor Evaluation

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Video coming September 2026

How to Perform

In good lighting, inspect the sites where color reflects the underlying capillaries and skin pigment is thin — the palpebral conjunctiva (gently pull down the lower lid), the nail beds, the palmar creases, and the lips and oral mucosa — and compare the color with the expected appearance. Note whether pallor is generalized or localized.

How to Interpret

Showing all 2 findings

Anemia

Clinical pallor in a child
Rule in
Somewhat helpful
Rule out
Minimally helpful
Evidence:Strong
Conjunctival pallor
Rule in
Somewhat helpful
Rule out
Minimally helpful
Evidence:Limited

References

  • Sheth TN, Choudhry NK, Bowes M, Detsky AS. The relation of conjunctival pallor to the presence of anemia. J Gen Intern Med. 1997 Feb;12(2):102-106. doi:10.1046/j.1525-1497.1997.00014.x. PMID: 9051559.
  • Chalco JP, Huicho L, Alamo C, Carreazo NY, Bada CA. Accuracy of clinical pallor in the diagnosis of anaemia in children: a meta-analysis. BMC Pediatr. 2005 Dec 8;5:46. doi:10.1186/1471-2431-5-46. PMID: 16336667.
  • Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
  • Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.