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Is there a history of drug use? Many drugs, including barbiturates and benzodiazepines, may cause a restless leg syndrome.
Are there abnormalities on neurologic examination? Various forms of peripheral ... DIAGNOSTIC WORKUP
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Is there a family history of migraine or epilepsy? Migraine and epilepsy both present with abdominal pain.
Is the pain colicky or persistent? Chronic colicky abdominal pain may be due to chronic cholecystitis, ... DIAGNOSTIC WORKUP
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Where is the pain located? If it is diffuse, one should consider pancreatitis, mesenteric artery occlusion, or ruptured peptic ulcer. In addition, another viscus may be perforated, such as a ruptured ectopic, and ... DIAGNOSTIC WORKUP
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Is the pain of acute onset or gradual onset? If it is acute onset, one must consider the possibility of epidural abscess, pyelonephritis, or other abdominal conditions as the cause of the back pain. If it is gradual onset, one ... DIAGNOSTIC WORKUP
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Is it unilateral or bilateral? Unilateral breast pain should make one think of an infectious process or advanced carcinoma. Bilateral breast pain should make one think of pregnancy. This may be a normal pregnancy or an ectopic pregnancy.
Is ... DIAGNOSTIC WORKUP
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Is the chest pain acute or chronic? If it is acute, one must consider acute myocardial infarction, pulmonary embolism, pneumothorax, pericarditis, and fractures. If the chest pain is chronic, one must consider chronic coronary ... DIAGNOSTIC WORKUP
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Is the extremity pain of acute or gradual onset? Acute onset would suggest arterial embolism, deep vein thrombophlebitis, and cellulitis. If there is a history of trauma, it would suggest a fracture, sprain, or torn ligament. ... DIAGNOSTIC WORKUP
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Is there limitation of motion of the joints? Limitation of motion of a joint would suggest not only various types of arthritis, fracture, or torn ligaments, but also inflammation of surrounding structures such as the bursa ... DIAGNOSTIC WORKUP
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Is there redness of the eye? Redness of the eye suggests definite eye pathology. Without redness, one should suspect disease in the adjacent structures or retrobulbar neuritis.
If there is redness, is there ... DIAGNOSTIC WORKUP
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Is the pain constant or intermittent? Intermittent pain would suggest trigeminal neuralgia, cluster headaches, or atypical migraine. Constant pain would suggest any local abnormalities in the structures underlying the face such as an ... DIAGNOSTIC WORKUP
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Is there associated fever? The presence of fever along with chest pain should make one think of a perinephric abscess or pyelonephritis. Occasionally, however, hypernephroma can cause fever and flank pain, as can bilateral ... DIAGNOSTIC WORKUP
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Are there abnormalities on inspection of the heel? Inspection of the heel may disclose an ulcer, foreign body, cellulitis, plantar wart, and other disorders.
Is the patient a child? Children often have Sever's disease ... DIAGNOSTIC WORKUP
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Is there a positive straight-leg raising test or other neurologic signs? The presence of positive straight-leg raising tests or other neurologic signs would suggest a herniated disk, a cauda equina tumor, or ... DIAGNOSTIC WORKUP
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Are there abnormalities on examination of the teeth or gums? A thorough examination of the teeth and gums may disclose dental caries, gingivitis, oral tumors, or alveolar abscess.
Is the pain intermittent? ... DIAGNOSTIC WORKUP
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Is the joint pain localized to a single joint? Localization to a single joint should suggest a septic arthritis, gout, tuberculosis, hemophilia, sickle cell disease, trauma, avascular necrosis, and pseudogout.
... DIAGNOSTIC WORKUP
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Restless legs are a common complaint that cannot simply be diagnosed as restless legs syndrome without an appropriate evaluation to assess for other etiologies. A careful sleep and medication history, coupled with a complete neurologic exam, are often all that is needed to... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Low back pain is the second most common cause of doctor visits in the U.S. and is the most common cause of disability. Up to 90% of the population will experience back pain during their lives. Studies show that, at any given time, up to 20% of the... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Lower abdominal pain is a common complaint that must be evaluated carefully and systematically to reach the appropriate diagnosis in timely manner. All diagnoses must be considered, with the most emergent etiologies rapidly ruled out, followed by a careful evaluation and treatment for the... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Upper abdominal pain is a common presenting symptom. A complete differential diagnosis should be developed based on the organs in the upper abdomen in addition to the associated history and physical examination. Gallbladder disease and... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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In evaluating an acute abdomen, rebound tenderness is one of the most important signs of peritonitis. It is elicited by pressing deeply on the abdomen and then suddenly releasing pressure, which stretches the peritoneum and causes increased abdominal... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Breast pain (or mastalgia) is a common complaint that can often be diagnosed by a careful history and physical examination. Pain and tenderness may be normal during early pregnancy and before menses. Breast discharge, however, is rarely normal except in... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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The elbow joint is formed by the radius, ulna, and distal humerus. Trauma is a common cause of injury. Injuries frequently result from falling on an outstretched hand and may be associated with nerve injuries (axillary, radial, ulnar, and/or median nerves); furthermore, the... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Pain and/or tenderness on the side of the trunk from the ribs to the ileum is often associated with renal disease; however, nonrenal etiologies are very common. Of course, renal disease should be strongly suspected in the case of costovertebral angle tenderness and concurrent urinary... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Jaw pain is a common presenting or incidental complaint; its etiology is often identified by a careful history and physical examination. In many cases, consultation with a dentist will aid in the diagnosis and treatment. In older patients (>55), be sure to rule out serious... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Primary care physicians, rheumatologists, and orthopedists frequently encounter complaints about the knee. Because the range of illnesses affecting the knee varies greatly, a thorough history and physical exam are essential. Once a differential... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Neck stiffness may be caused by inflammation, infection, or trauma. True nuchal rigidity is characterized by the inability to actively or passively touch the chin to the chest and is due to inflammation of the brain and spinal cord. A positive... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Pelvic pain is a common primary care complaint that should be distinguished as acute (<6 months) versus chronic (>6 months), and cyclic, noncyclic, or pregnancy-related. Gynecologic, urologic, and intestinal etiologies are common, but psychological,>... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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The shoulder is a complex arrangement of the humerus held loosely in place by ten muscles acting on the scapula, clavicle, and humerus, which form three articulations (acromioclavicular, glenohumeral, and sternoclavicular). Acute injuries are generally due to... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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The wrist is composed of eight carpal bones that are held in alignment by a series of ligaments and cartilaginous connective tissue. Wrist pain is fairly common in primary care. Although carpal tunnel syndrome is one of the most common etiologies of wrist pain, pain... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Seizures are a symptom of some identifiable underlying cause or are idiopathic. Epilepsy is recurrent unprovoked seizures. Seizures may or may not be associated with convulsive activity. Correct classification of the seizure type helps to suggest etiology and treatment.
... Workup and Diagnosis ... Treatment
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Not all ear pain is otologic; the ears have rich sensory innervation from multiple nerves, and secondary pain is common. Most otologic ear pain has some associated physical findings; if none is present, a complete head and neck examination, including imaging,... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Febrile seizures occur in 3–4% of all children; they often do not require long-term treatment. Each year, between 25,000 and 40,000 children in the U.S. have a first unprovoked afebrile seizure. Most of these children will not have a second seizure and do not require... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Seizures in the newborn are often difficult to diagnose, because there may only be subtle manifestations. Any insult that affects the brain in this age group can present with seizures, thus the differential diagnosis is quite extensive. One also has... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Abdominal pain is a frequent complaint and associated with an enormous number of causes. Many causes of acute abdominal pain require surgical intervention, so a prompt diagnosis is needed. Diagnostic clues would include the location of the pain. Traditionally, the farther... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Back pain is an uncommon complaint in children, but relatively more common in adolescents. Although relatively benign causes (such as muscular strain in adolescents) account for the majority of cases, some more severe causes should not be overlooked, especially in younger... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Chest pain is a frequent complaint in pediatrics, especially in the adolescent age group. Although rarely cardiac in etiology, this often represents the patient's/family's greatest fear. A careful history and physical exam, with attention to the needs of the patient... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Hip pain encompasses a broad differential that relies on a focused and detailed history to determine the acute and emergent diagnoses from the less urgent hip problems. The most urgent diagnosis to make is septic arthritis, and the most challenging etiologies to manage... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Knee pain is a common complaint that is readily evaluated by focusing on the anatomic structures. A focused history and exam will often give the diagnosis. Because hip pain can radiate to the knee, a thorough lower extremity exam should always be performed.
... Workup and Diagnosis ... Treatment
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Toeing out, or out-toeing, is not as common as intoeing. Excessive out-toeing is considered a normal variant. Observation and parental reassurance are the mainstays of therapy.
Differential Diagnosis
Femoral retroverson – ... Workup and Diagnosis ... Treatment
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Toeing in, or intoeing, is a commonly referred problem to orthopedic surgeons. The mainstay of treatment includes parental reassurance. Symtoms in the majority of patients resolve spontaneously by 8 years old.
Differential Diagnosis
... Workup and Diagnosis ... Treatment
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Acute scrotal pain demands immediate attention. Although not every cause constitutes an emergency, testicular torsion must be discovered immediately to save the testicle. Testicular pain should be triaged to an emergency center with access to Doppler evaluation and a surgery... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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With asymmetry of body parts, it can be difficult to differentiate whether one side is hypertrophic or the other side is atrophic. One of the most common asymmetries seen in children is leg-length discrepancy. Growth disturbances around the knee have a substantial effect on leg length,... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... The differential diagnosis of this sign is similar to the differential diagnosis of tremors (see page 521), but a few additional possibilities should be kept in mind. Idiopathic myoclonus epilepsy, petit mal epilepsy (with the petit mal triad),
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... The GI tract is the only “organ” that really covers the abdomen from one end to the other. Anything that causes an irritation of all or a large portion of this “tube” may cause generalized abdominal pain. Thus, gastritis, viral and bacterial gastroenteritis,
... READ EXCERPTS »
... Nothing is more challenging to diagnose than a case of low back pain. That is why it is so important to have an extensive list of causes in mind before approaching the patient. Anatomy forms the basis for developing such a list ( Table 45
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... An anatomic breakdown of the arm into its components is the key to a sound differential diagnosis in arm pain. Pain may be referred from more proximal portions of the extremity such as the shoulder (e.g., bursitis) or brachial plexus (e.g.,
... READ EXCERPTS »
... Division of the breast anatomically into various components is interesting but not worthwhile in the differential diagnosis of breast pain. It is rather more instructive and practical to use VINDICATE in developing a list of causes of this symptom.
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... Hardly a day goes by in a busy practitioner’s office that he or she is not confronted with a patient complaining of chest pain. The main concern, of course, is to exclude an acute myocardial infarction, which is not an easy task in many cases. The practitioner frequently admits the
... READ EXCERPTS »
... A painful elbow really does not require a detailed analysis of the anatomy to discover the various causes, almost all of which are bursal or bone and joint disorders. Of course, the skin may be involved by trauma and infection, just like the skin of the hands (see page 453
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... By mental dissection of the epigastrium layer by layer from the skin to the thoracolumbar spine, one encounters all the important organs that are the sites of origin of epigastric pain ( Table 11 ). Anatomy, therefore, is the
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... Applying the mnemonic MINT to the various anatomic parts of the eye will aid in systematically developing a list of diagnostic possibilities for eye pain.
M—Malformations most certainly suggest glaucoma and all the refractive disorders (e.g.,
... READ EXCERPTS »
... Visualize the structures of the face in a systematic fashion to develop a differential diagnosis of facial pain. With the skin, herpes zoster and carbuncles come to mind. Next, the internal maxillary artery suggests histamine cephalalgia and arteritis, just as the nerves
... READ EXCERPTS »
... Most cases of flank pain are associated with inflammation of the kidney. As is shown in Table 29 , however, jumping to that conclusion in any given case may be hazardous.
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... The anatomic components of the groin consist of the skin, subcutaneous tissue, fascia, lymph nodes, the femoral nerve, arteries and veins, and underneath, the hip bones. With these components in mind, it should be easy to develop a differential diagnosis of groin
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... Visualize the anatomy when a patient presents with pain in the hand or fingers ( Table 31 ). The skin may show contact dermatitis, fungal infection, furuncle, cellulitis, or traumatic lesion. An insignificant wound may be
... READ EXCERPTS »
... When confronted with a case of hip pain in an adult, the clinician is most likely to think of fracture or joint inflammation such as osteoarthritis, realizing however that there are many other possibilities ( Table 38 ). How can the clinician think of
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... Because most joints may be affected by the same etiologic processes, a general discussion of the differential diagnosis of joint pain will be undertaken, followed by a discussion of exceptions that apply to certain joints.
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... Myoclonus — sudden, shocklike contractions of a single muscle or muscle group — occurs with various neurologic disorders and may herald the onset of a seizure. These contractions may be isolated or repetitive, rhythmic or arrhythmic, symmetrical... Emergency Interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... An unreliable indicator of cancer, breast pain commonly results from benign breast disease. It may occur during rest or movement and may be aggravated by manipulation or palpation. (Breast tenderness refers to pain elicitedby physical contact.) Breast pain... History and physical examination ... Medical causes ... Special considerations ... Pictures
... READ EXCERPTS »
... Absence seizures are benign, generalized seizures thought to originate subcortically. These brief episodes of unconsciousness usually last 3 to 20 seconds and can occur 100 or more times per day, causing periods of inattention. Absence seizures usually begin... History and physical examination ... Medical causes
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... A complex partial seizure occurs when a focal seizure begins in the temporal lobe and causes a partial alteration of consciousness — usually confusion. Psychomotor seizures can occur at any age, but their incidence usually increases... History ... Medical causes ... Special considerations ... Pediatric pointers
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... Like other types of seizures, generalized tonic-clonic seizures are caused by the paroxysmal, uncontrolled discharge of central nervous system neurons, leading to neurologic dysfunction. Unlike most other types of seizures, however, this cerebral... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... Resulting from an irritable focus in the cerebral cortex, simple partial seizures typically last about 30 seconds and don’t alter the patient’s level of consciousness (LOC). The type and pattern reflect the location of the irritable focus. Simple partial... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Pictures
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... Abdominal pain usually results from a GI disorder, but it can be caused by a reproductive, genitourinary (GU), musculoskeletal, or vascular disorder; drug use; or ingestion of toxins. At times, such pain signals life-threatening complications.
Abdominal pain... Emergency interventions
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... Arm pain usually results from musculoskeletal disorders, but it can also stem from neurovascular or cardiovascular disorders. (See Causes of local pain.) In some cases, it may be referred pain from another area, such as the chest, neck, or abdomen. Its location, onset, and... History and physical examination ... Medical causes ... Special considerations ... Pictures
... READ EXCERPTS »
... Back pain affects an estimated 80% of the population; in fact, it's the second leading reason — after the common cold — for lost time from work. Although this symptom may herald a spondylogenic disorder, it may also result from a genitourinary, GI, cardiovascular,... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations
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... Chest pain usually results from disorders that affect thoracic or abdominal organs — the heart, pleurae, lungs, esophagus, rib cage, gallbladder, pancreas, or stomach. An important indicator of several acute and life-threatening cardiopulmonary and GI disorders, chest... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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Eye pain may be described as a burning, throbbing, aching, or stabbing sensation in or around the eye. It may also be characterized as a foreign-body sensation. This sign varies from mild to severe; its duration and exact location provide clues to the causative disorder. ... Emergency interventions ... History and physical examination ... Pictures
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... Pain in the flank, the area extending from the ribs to the ilium, is a leading indicator of renal and upper urinary tract disease or trauma. Depending on the cause, this symptom may vary from a dull ache to severe stabbing or throbbing pain, and may be... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Pictures
... READ EXCERPTS »
... Jaw pain may arise from either of the two bones that hold the teeth in the jaw — the maxilla (upper jaw) and the mandible (lower jaw). Jaw pain also includes pain in the temporomandibular joint (TMJ), where the mandible meets the temporal bone.... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Neck pain may originate from any neck structure, ranging from the meninges and cervical vertebrae to its blood vessels, muscles, and lymphatic tissue. This symptom can also be referred from other areas of the body. Its location, onset, and pattern help determine the origin and... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Pictures
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... A common symptom of anorectal disorders, rectal pain is discomfort that arises in the anorectal area. Although the anal canal is separated from the rest of the rectum by the internal sphincter, the patient may refer to all local pain as rectal pain.
Because the mucocutaneous... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers
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... Central Nervous System and Vascular Causes
Cerebrovascular disease
Thrombosis
Embolism
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... Diffuse
Gastroenteritis
Peritonitis
Pancreatitis
Leukemia
Sickle cell crisis
Early appendicitis (may be periumbilical)
... READ EXCERPTS »
... Abdominal Disorders
Inflammatory disorders
Peritoneum
Peritonitis (chemical or bacterial)
Subdiaphragmatic
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... Functional, mechanical causes: postural imbalance
Anteroposterior (e.g., pregnancy)
Lateral (e.g., scoliosis, unequal leg lengths)
Trauma
... READ EXCERPTS »
... Skin and subcutaneous lesions [including adiposis dolorosa, thrombophlebitis of thoracoepigastric vein (Mondor's disease)]
Breast lesions
Fibroadenosis
... READ EXCERPTS »
... Chest Wall Disease
Bony thorax
Costochondritis (Tietze's syndrome)
Rib fracture or tumor
... READ EXCERPTS »
... Fracture
Contusion
Acromial-clavicular joint separation or injuries
Rotator cuff tendinitis or impingement syndrome
Bursitis
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... Complex regional pain syndrome (CRPS), also known as reflex sympathetic dystrophy (CRPS1) or causalgia (CRPS2), is a chronic pain disorder that results from abnormal healing after an injury — either minor or major — to a bone, muscle, or nerve. The... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... The striking feature of pain disorder is a persistent complaint of pain in the absence of appropriate physical findings. The symptoms are either inconsistent with the normal anatomic distribution of the nervous system or they mimic a disease (such as angina) in the absence of... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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... Myoclonus—sudden, shocklike contractions of a single muscle or muscle group—occurs with various neurologic disorders and may herald onset of a seizure. These contractions may be isolated or repetitive, rhythmic or arrhythmic, symmetrical or asymmetrical, synchronous... Emergency Interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
... READ EXCERPTS »
... An unreliable indicator of cancer, breast pain commonly results from benign breast disease. It may occur during rest or movement and may be aggravated by manipulation or palpation. (Breast tenderness refers to pain elicitedby physical contact.)... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Eye pain may be described as a burning, throbbing, aching, or stabbing sensation in or around the eye. It may also be characterized as a foreign-body sensation. This sign varies from mild to severe; its duration and exact location provide clues... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Absence seizures are benign, generalized seizures thought to originate subcortically. These brief episodes of unconsciousness usually last 3 to 20 seconds and can occur 100 or more times a day, causing periods of inattention. Absence seizures usually begin between ages 4... History and physical examination ... Medical causes ... Patient counseling
... READ EXCERPTS »
... A complex partial seizure occurs when a focal seizure begins in the temporal lobe and causes a partial alteration of consciousness—usually confusion. Psychomotor seizures can occur at any age, but incidence usually increases during... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers
... READ EXCERPTS »
... Like other types of seizures, generalized tonic-clonic seizures are caused by the paroxysmal, uncontrolled discharge of central nervous system (CNS) neurons, leading to neurologic dysfunction. Unlike most other types of seizures, however, this... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Resulting from an irritable focus in the cerebral cortex, simple partial seizures typically last about 30 seconds and don’t alter the patient’s level of consciousness (LOC). The type and pattern reflect the location of the irritable focus. Simple partial... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Abdominal pain usually results from a GI disorder, but it can also be caused by a reproductive, genitourinary (GU), musculoskeletal, or vascular disorder; drug use; or ingestion of toxins. At times, such pain signals life-threatening complications.
Abdominal pain arises... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
... READ EXCERPTS »
... Arm pain usually results from musculoskeletal disorders, but it can also stem from neurovascular or cardiovascular disorders. (See Causes of localized arm pain, page 74.) In some cases, arm pain may be referred from another area, such as... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Back pain affects an estimated 80% of the population; in fact, it’s the second leading reason—after the common cold—for lost time from work. Although this symptom may herald a spondylogenic disorder, it may also result from a genitourinary, GI,... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Chest pain usually results from disorders that affect thoracic or abdominal organs—the heart, pleurae, lungs, esophagus, rib cage, gallbladder, pancreas, or stomach. An important indicator of several acute and life-threatening cardiopulmonary and GI... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Facial pain may result from various neurologic, vascular, or infectious disorders. The most common cause of facial pain is trigeminal neuralgia (tic douloureux). In this disorder, intense, paroxysmal facial pain may occur along the pathway of a specific... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Pain in the flank, the area extending from the ribs to the ilium, is a leading indicator of renal and upper urinary tract disease or trauma. Depending on the cause, this symptom may vary from a dull ache to severe stabbing or throbbing pain, and may be unilateral or bilateral and constant... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Pictures
... READ EXCERPTS »
... Jaw pain may arise from either of the two bones that hold the teeth in the jaw—the maxilla (upper jaw) and the mandible (lower jaw). Jaw pain also includes pain in the temporomandibular joint (TMJ), where the mandible meets the temporal bone.
Jaw... Emergency Interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
... READ EXCERPTS »
... Neck pain may originate from any neck structure, ranging from the meninges and cervical vertebrae to its blood vessels, muscles, and lymphatic tissue. This symptom can also be referred from other areas of the body. Its location, onset, and pattern help... Emergency Interventions ... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Pictures
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... Linda M. Savory
Seizures are a common serious neurologic disorder in the outpatient setting. In the United States, approximately 4 million patients suffer at least one seizure and 2 million have suffered two or more. Approximately 10% of these... Approach. ... History. ... Physical examination (PE) ... Testing ... Diagnostic assessment.
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... Jim Nuovo
Atypical chest pain is defined as pain that does not have a characteristic anginal quality (heaviness or squeezing sensation), precipitating factors (e.g., exertion), or location (substernal and radiating).
... History ... Physical examination ... Testing ... Diagnostic assessment
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... Marie K. Yamamotoya
Substernal chest pain requires a rapid and accurate assessment to identify potentially life-threatening events. Substernal chest pain of cardiac origin encompasses the entire clinical spectrum from typical angina to unstable... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
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... Stephen Davis
Approach Low back pain is a common problem with many causes. The differential diagnosis can be grouped into three over-lapping categories: urgent (“red flag”) diagnoses, structural (musculoskeletal)... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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... Margaret A. Tryforos
Approach Evaluation of monarticular joint pain should differentiate inflammatory from degenerative conditions and clarify whether immediate treatment is needed to prevent permanent joint damage.... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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... Richard W. Emerine
Abdominal pain of varying causes, ranging from the functional to the organic, is one of the top ten outpatient complaints; it is the chief complaint for 5% to 10% of patients presenting to emergency departments (1). ... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
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... Alicia J. Curtin
Calf pain, a common complaint that has many causes, can pose a challenge diagnostically.
Approach Assess potential risk factors and the chronology of events. Common causes of calf pain are listed in... History ... Physical examination (PE) ... Testing ... Diagnostic assessment ... Pictures
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... Albert A. Meyer
Approach A woman has an approximate 5% chance of having chronic pelvic pain in her lifetime (1). It is defined as an episodic or continuous pain that persists for 6 months or longer, sufficiently severe to have a significant... History ... Physical examination ... Testing (3) ... Diagnostic assessment
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... Meredith A. Goodwin and Elise M. Coletta
Approach The evaluation of hip pathology is challenging for several reasons. Compared with other joints, the hip is relatively inaccessible to palpation and evaluation. Hip pathology can... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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... Charles B. Eaton
Knee pain is a very common condition, ranking number seven in the National Ambulatory Care survey. It has been suggested that 90% of knee pain in patients can be diagnosed after an appropriate history and knee examination.
... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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... Elise M. Coletta and Meredith A. Goodwin
Approach The differential diagnosis for neck pain can be thought of by pattern of onset (Table 12.8). Disease, which can originate in the neck, can be felt there or elsewhere. The neck is also a... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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... Hal S. Shimazu
Pleuritic pain is the characteristic pain of inflamed pleura (i.e., pleurisy—a term often used synonymously with pleuritic pain). Pleuritic pain arises from parietal pleura and is typically sharp, stabbing,... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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... Gowri Anandarajah
Shoulder pain is the second most frequent orthopedic complaint seen in the primary care setting (1). The joint’s complex anatomy, versatile range of motion, and central location make accurate diagnosis a... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment (3,4) ... Pictures
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... George R. Wilson
Approach Most patients seen with scrotal pain are adults and have either epididymitis (1) or varicocele. However, the patient presenting with testicular torsion represents a surgical emergency requiring... History ... Physical examination ... Testing ... Diagnostic assessment
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... Differential Overview
❑ Generalized (grand mal)
❑ Partial (focal)
❑ Complex partial (temporal lobe)
❑ Absence (petit mal) ... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
❑ Irritable bowel syndrome
❑ Peptic ulcer disease
❑ Cholecystitis
❑ Chronic pancreatitis
❑ Inflammatory bowel... Diagnostic Approach ... Clinical Findings
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... Differential Overview
❑ Costochondritis
❑ Pneumonia
❑ Rib fracture
❑ Pulmonary embolism
❑... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
Pain Predominant
❑ Epididymitis
❑ Testicular torsion
❑ Prostatitis
❑ Referred pain ... Diagnostic Approach ... Clinical Findings
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... Differential Overview
❑ Chest wall pain
❑ Angina
❑ Unstable angina
❑ Myocardial infarction
&... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
Ear Pain
❑ Acute otitis media
❑ Acute otitis externa
❑ Eustachian dysfunction
❑ Temporomandibular... Diagnostic Approach ... Clinical Findings
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... Differential Overview
❑ Maxillary sinusitis
❑ Dental infection
❑ Temporomandibular joint dysfunction
❑ Myofascial masseter pain ... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
❑ Musculoligamentous strain
❑ Lumbar disc herniation
❑ Osteoarthritis
❑ ... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
Generalized/Periumbilical
❑ Gastroenteritis
❑ Obstipation
❑ Small bowel obstruction
❑ Large bowel... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
❑ Osteoarthritis
❑ Patellofemoral pain
❑ Collateral ligament sprain
❑ Meniscal tear
... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
Ankle Pain
❑ Ankle sprain
❑ Fibular fracture
❑ Achilles tendinitis ... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
❑Lateral epicondylitis
❑Olecranon bursitis
❑Medial epicondylitis
❑Bicipitoradialis tendinitis ... Diagnostic Approach ... Clinical Findings
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... Differential Overview
❑ Conjunctivitis
❑ Corneal abrasion
❑ Foreign body
❑ Sinusitis
❑... Diagnostic Approach ... Clinical Findings
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... Differential Overview
❑ Ureteral calculus
❑ Acute pyelonephritis
❑ Latissimus strain
❑ Perinephric abscess
❑... Diagnostic Approach ... Clinical Findings
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... Differential Overview
❑Hip osteoarthritis
❑Trochanteric bursitis
❑Ischial bursitis
❑Iliopectineal bursitis
❑... Diagnostic Approach ... Clinical Findings
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... Complex regional pain syndrome (CRPS), also known as reflex sympathetic dystrophy (CRPS1) or causalgia (CRPS2), is a chronic pain disorder that results from abnormal healing after an injury — either minor or major — to a bone, muscle, or nerve. The development of... Causes ... Signs and symptoms ... Diagnostic tests ... Treatment ... Special considerations
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... Myoclonus — sudden, shocklike contractions of a single muscle or muscle group — occurs with various neurologic disorders and may herald onset of a seizure. These contractions may be isolated or repetitive, rhythmic or arrhythmic,... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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... Like other types of seizures, generalized tonic-clonic seizures are caused by the paroxysmal, uncontrolled discharge of central nervous system (CNS) neurons, leading to neurologic dysfunction. Unlike most other types of seizures, however, this cerebral hyperactivity... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Abdominal pain usually results from a GI disorder, but can also be caused by drug use, ingestion of toxins, or disorders of the reproductive, genitourinary (GU), musculoskeletal, or vascular systems. At times, such pain signals life-threatening complications. ... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Back pain affects an estimated 80% of the population and is the second leading cause of absence from work. Although this symptom may indicate a spondylogenic disorder, it may also result from a genitourinary, GI, cardiovascular, or neoplastic disorder.... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Disorders that affect thoracic or abdominal organs — the heart, pleurae, lungs, esophagus, rib cage, gallbladder, pancreas, or stomach — are typical causes of chest pain. It can also result from a musculoskeletal or hematologic disorder, anxiety, and drug therapy. Chest pain... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Eye pain may be described as a burning, throbbing, itching, aching, or stabbing sensation in or around the eye. It may also be characterized as a foreign-body sensation. This sign varies from mild to severe; its duration and exact location provide clues to the causative disorder. ... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Pain in the flank, the area extending from the ribs to the ilium, is a leading indicator of renal and upper urinary tract disease or trauma. Depending on the cause, this symptom may vary from a dull ache to severe stabbing or throbbing pain, and may be unilateral or bilateral... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
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... Jaw pain may arise from either of the two bones that hold the teeth in the jaw — the maxilla (upper jaw) and the mandible (lower jaw). Jaw pain also includes pain in the temporomandibular joint (TMJ), where the mandible meets the temporal bone. ... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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... Neck pain may originate from any neck structure, ranging from the meninges and cervical vertebrae to its blood vessels, muscles, and lymphatic tissue. This symptom can also be referred from other areas of the body. Its location, onset, and pattern help... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
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... Myoclonus — sudden, shocklike contractions of a single muscle or muscle group — occurs with various neurologic disorders and may herald onset of a seizure. These contractions may be isolated or repetitive, rhythmic or arrhythmic, symmetrical or asymmetrical, synchronous or... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... A complex partial seizure occurs when a focal seizure begins in the temporal lobe and causes a partial alteration of consciousness — usually confusion. Psychomotor seizures can occur at any age, but incidence usually increases during adolescence and... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... Like other types of seizures, generalized tonic-clonic seizures are caused by the paroxysmal, uncontrolled discharge of central nervous system (CNS) neurons, leading to neurologic dysfunction. Unlike most other types of seizures, however, this cerebral... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... Resulting from an irritable focus in the cerebral cortex, simple partial seizures typically last about 30 seconds and don’t alter the patient’s level of consciousness (LOC). The type and pattern reflect the location of the irritable focus. Simple partial seizures... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... Abdominal pain usually results from a GI disorder, but it can be caused by a reproductive, genitourinary (GU), musculoskeletal, or vascular disorder; drug use; or ingestion of toxins. At times, such pain signals life-threatening complications.
... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Arm pain usually results from musculoskeletal disorders, but it can also stem from neurovascular or cardiovascular disorders. In some cases, it may be referred pain from another area, such as the chest, neck, or abdomen. Its location, onset, and character provide clues to its cause.... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Back pain affects an estimated 80% of the U.S. population; in fact, it’s the second leading reason — after the common cold — for lost time from work. Although this symptom may herald a spondylogenic disorder, it may also result from a... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... An unreliable indicator of cancer, breast pain commonly results from benign breast disease. Also known as mastalgia, breast pain may occur during rest or movement and may be aggravated by manipulation or palpation. (Breast tenderness... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Chest pain usually results from disorders that affect thoracic or abdominal organs — the heart, pleurae, lungs, esophagus, rib cage, gallbladder, pancreas, or stomach. An important indicator of several acute and life-threatening cardiopulmonary and GI disorders, chest pain... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Eye pain, or ophthalmalgia, may be described as a burning, throbbing, aching, or stabbing sensation in or around the eye. It may also be characterized as a foreign-body sensation. This sign varies from mild to severe; its duration and exact... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Facial pain may result from various neurologic, vascular, or infectious disorders. The most common cause of facial pain is trigeminal neuralgia (tic douloureux). Typically paroxysmal and intense, facial pain may occur along the pathway of a... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... Pain in the flank, the area extending from the ribs to the ilium, is a leading indicator of renal and upper urinary tract disease or trauma. Depending on the cause, this symptom may vary from a dull ache to severe stabbing or throbbing pain,... Emergency Actions ... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Jaw pain may arise from either of the two bones that hold the teeth in the jaw — the maxilla (upper jaw) and the mandible (lower jaw). Jaw pain also includes pain in the temporomandibular joint (TMJ), where the mandible meets the temporal bone. (See Associated... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... Neck pain may originate from any neck structure, ranging from the meninges and cervical vertebrae to its blood vessels, muscles, and lymphatic tissue. This symptom can also be referred from other areas of the body. Its location, onset, and pattern... Emergency Actions ... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... A common symptom of anorectal disorders, rectal pain is discomfort that arises in the anorectal area. Although the anal canal is separated from the rest of the rectum by the internal sphincter, the patient may refer to all local pain as rectal pain.
... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... A seizureis a sudden paroxysmal discharge of neurons that causes a transientalteration in neurologic function. This alteration can include changesin level of alertness, sensation, motor activity, and autonomicfunction. Commission on Classification and Terminologyof the... Classification of Seizure Types ... Principal Causes of Seizures ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... Many diseasescause abdominal pain, and clinical dilemma is to distinguish life-threateningones from those that are mild and self-limited. Best way to approach diagnosis is toconsider age of child and whether pain is acute or chronic. Principal ... Clinical Features and Diagnosis: Acute Abdominal Pain ... Diagnostic Approach: Acute Abdominal Pain ... Principal Causes of Chronic or Recurrent Abdominal Pain ... Diagnostic Approach: Chronic or Recurrent Abdominal Pain ... References
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...Although less common in children than inadults, a specific cause can frequently be identified. Principal Causes of Back Pain Congenital Spineanomalies Developmental Scoliosis Scheuermann disease ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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...Although chest pain is common complaint inchildren and adolescents, serious underlying disease presentingas chest pain is uncommon in this population. Principal Causes of Chest Pain Musculoskeletaldisorders Muscle Trauma(strain, contusion, laceration) ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... Myoclonus—sudden, shocklike contractions of a single muscle or muscle group—occurs with various neurologic disorders and may herald the onset of a seizure. These contractions may be isolated or repetitive, rhythmic or arrhythmic,... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... An unreliable indicator of cancer, breast pain commonly results from benign breast disease. It may occur during rest or movement and may be aggravated by manipulation or palpation. (Breast tenderness refers to pain elicited by physical contact.) Breast pain may be unilateral... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... Eye pain may be described as a burning, throbbing, aching, or stabbing sensation in or around the eye. It may also be characterized as a foreign-body sensation. This sign varies from mild to severe; its duration and exact location provide clues to the causative... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Absence seizures are benign, generalized seizures thought to originate subcortically. These brief episodes of unconsciousness usually last 3 to 20 seconds and can occur 100 or more times per day, causing periods of inattention. Absence seizures usually... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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... A complex partial seizure occurs when a focal seizure begins in the temporal lobe and causes a partial alteration of consciousness—usually confusion. Psychomotor seizures can occur at any age, but their incidence usually increases during... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... Like other types of seizures, generalized tonic-clonic seizures are caused by the paroxysmal, uncontrolled discharge of central nervous system neurons, leading to neurologic dysfunction. Unlike most other types of seizures, however, this cerebral hyperactivity isn't confined to the original... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Resulting from an irritable focus in the cerebral cortex, simple partial seizures typically last about 30 seconds and don't alter the patient's level of consciousness (LOC). The type and pattern reflect the location of the irritable focus. Simple partial seizures may be... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Abdominal pain usually results from a GI disorder, but it can be caused by a reproductive, genitourinary (GU), musculoskeletal, or vascular disorder; drug use; or ingestion of toxins. At times, such pain signals life-threatening complications. ... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Arm pain usually results from musculoskeletal disorders, but it can also stem from neurovascular or cardiovascular disorders. (See Causes of local pain, page 52.)
In some cases, it may be referred pain from another area, such as the chest, neck, or... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Back pain affects an estimated 80% of the population; in fact, it's the second leading reason—after the common cold—for lost time from work. Although this symptom may herald a spondylogenic disorder, it may also result from a genitourinary, GI, cardiovascular, or... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... Chest pain usually results from disorders that affect thoracic or abdominal organs—the heart, pleurae, lungs, esophagus, rib cage, gallbladder, pancreas, or stomach. An important indicator of several acute and life-threatening cardiopulmonary and GI disorders, chest pain can... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Pain in the flank, the area extending from the ribs to the ilium, is a leading indicator of renal and upper urinary tract disease or trauma. Depending on the cause, this symptom may vary from a dull ache to severe stabbing or throbbing pain, and may be unilateral or... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... Jaw pain may arise from either of the two bones that hold the teeth in the jaw—the maxilla (upper jaw) and the mandible (lower jaw). Jaw pain also includes pain in the temporomandibular joint (TMJ), where the mandible meets the temporal bone.... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... Neck pain may originate from any neck structure, ranging from the meninges and cervical vertebrae to its blood vessels, muscles, and lymphatic tissue. This symptom can also be referred from other areas of the body. Its location, onset, and pattern help... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... A common symptom of anorectal disorders, rectal pain is discomfort that arises in the anorectal area. Although the anal canal is separated from the rest of the rectum by the internal sphincter, the patient may refer to all local pain as rectal... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
...
The GI tract is the only “organ” that really covers the abdomen
from one end to the other. Anything that causes an irritation of all or a
large portion of this “tube” may cause generalized abdominal pain. Thus,
gastritis, viral... Pictures
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...
Nothing is more challenging to diagnose than a case of low back pain.
That is why it is so important to have an extensive list of causes in mind
before approaching the patient. Anatomy forms the basis for
developing such a list (Table... Pictures
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...
An anatomic breakdown of the arm into its components is the key
to a sound differential diagnosis in arm pain. Pain may be referred from
more proximal portions of the extremity such as the shoulder (e.g.,
bursitis) or brachial plexus (e.g., cervical rib), so... Pictures
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...
Division of the breast anatomically into various components is
interesting but not worthwhile in the differential diagnosis of breast pain.
It is rather more instructive and practical to use VINDICATE in
developing a list of causes of this... Pictures
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...
Hardly a day goes by in a busy practitioner’s office that he or she is
not confronted with a patient complaining of chest pain. The main concern,
of course, is to exclude an acute myocardial infarction, which is not an
easy task in many cases. The practitioner... Pictures
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...
A painful elbow really does not require a detailed analysis of the
anatomy to discover the various causes, almost all of which are bursal or
bone and joint disorders. Of course, the skin may be involved by trauma and
infection, just... Pictures
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...
By mental dissection of the epigastrium layer by layer from the skin to
the thoracolumbar spine, one encounters all the important organs that are
the sites of origin of epigastric pain (Table 11). Anatomy,
therefore... Pictures
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...
Applying the mnemonic MINT to the various anatomic parts of the
eye will aid in systematically developing a list of diagnostic possibilities
for eye pain.
M—Malformations most certainly suggest... Pictures
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...
Visualize the structures of the face in a systematic fashion to develop
a differential diagnosis of facial pain. With the skin, herpes zoster
and carbuncles come to mind. Next, the internal maxillary artery
suggests histamine cephalalgia and... Pictures
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...
Most cases of flank pain are associated with inflammation of the
kidney. As is shown in Table 29, however, jumping to that
conclusion in any given case may be hazardous.
FLANK
...
Pictures
...
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...
The anatomic components of the groin consist of the skin, subcutaneous
tissue, fascia, lymph nodes, the femoral nerve, arteries and veins, and
underneath, the hip bones. With these components in mind, it should be easy
to develop a differential diagnosis of... Pictures
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...
Visualize the anatomy when a patient presents with pain in the hand or
fingers (Table 31). The skin may show contact dermatitis,
fungal infection, furuncle, cellulitis, or traumatic lesion. An
insignificant wound may be infected; if there... Pictures
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...
When confronted with a case of hip pain in an adult, the clinician is
most likely to think of fracture or joint inflammation such as
osteoarthritis, realizing however that there are many other possibilities
(Table 38). How can the clinician think of them on the... Pictures
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...
Because most joints may be affected by the same etiologic processes, a
general discussion of the differential diagnosis of joint pain will be
undertaken, followed by a discussion of exceptions that apply to certain
joints.
Anatomic and... Pictures
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...
The anatomy of the LLQ, like that of the RLQ, provides a basis for
recalling the causes of pain. There are fewer structures to deal with; thus,
the differential diagnosis is not difficult. Visualizing the structures
layer by layer, there are the skin and... Pictures
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... Author:
David Stockwell, MD
What To Do - Make a Decision
An important responsibility of physicians who care for children is treating
pain and suffering when possible. Several studies have documented that a ... Suggested Readings
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