TONGUE PAIN
TONGUE PAIN: Excerpt from Differential Diagnosis in Primary Care
Examination of the tongue is a time-honored important diagnostic aid, but in my experience, it is unusual for patients to present with pain in the tongue. Nevertheless, there is a plethora of causes. The mnemonic VINDICATE lends itself best to prompting the recall of these causes.
- V—Vascular suggests pernicious and iron deficiency anemia.
- I—Inflammation recalls Vincent stomatitis, herpes simplex, tuberculosis, and syphilis. The referred pain from gingivitis and abscessed teeth should also be considered here.
- N—Neoplasms remind one that carcinoma of the tongue often presents with pain.
- D—Degenerative and deficiency diseases remind one of pellagra and other avitaminoses.
- I—Intoxication and idiopathic call to mind tobacco, plumbism, mercurialism, and glossopharyngeal or trigeminal neuralgia.
- C—Congenital anomalies of the tongue are rare.
- A—Allergic and autoimmune diseases, on the other hand, suggest dermatomyositis and angioneurotic edema.
- T—Trauma suggests the numerous times we bite our tongues and may prompt a search for epilepsy when a patient presents with syncope.
- E—Endocrine reminds one of hypothyroidism.
Approach to the Diagnosis
The approach to the diagnosis includes a CBC, sedimentation rate, serum B12 and folic acid levels, serum ferritin, serology, tuberculin test, and perhaps biopsy of the lesion. A trial of vitamin therapy may be indicated.
Book Source Details
- Book Title: Differential Diagnosis in Primary Care
- Author(s): R. Douglas Collins
- Year of Publication: 2007
- Copyright Details: Differential Diagnosis in Primary Care, Copyright © 2007 Lippincott Williams & Wilkins.
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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
» Next page: SMOOTH TONGUE AND OTHER CHANGES (Differential Diagnosis in Primary Care)
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