...
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 ... DIAGNOSTIC WORKUP
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... Pain in the tongue is rarely an isolated symptom. There is usually a focal or diffuse inflammation of the tongue or an ulcerating lesion. Diffuse inflammation is found in antibiotic glossitis, glossitis of avitaminosis ... 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. ... 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 ... 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 ... 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, ... 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 ... 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 ... 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 ... DIAGNOSTIC WORKUP
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Is the pain constant or intermittent? Intermittent pain would suggest trigeminal neuralgia, cluster headaches, or atypical migraine. Constant ... 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, ... DIAGNOSTIC WORKUP
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Is there fever or localized erythema? Localized erythema would suggest phlebitis, gout, osteomyelitis, cellulitis, ingrown toenail, and paronychia. The presence of fever would make ... DIAGNOSTIC WORKUP
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Is there an associated rash? Presence of a rash, whether it is macular or vesicular, especially if it is in a dermatomal distribution, would suggest herpes zoster. Occasionally, herpes ... 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 ... 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 ... DIAGNOSTIC WORKUP
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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... 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,... 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... 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... 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... 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... 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... 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... 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... 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... 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>... 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... 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... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Ankle pain is a common problem that generally occurs secondary to acute or chronic injury or degenerative joint disease. Ankle sprains, most commonly due to traumatic inversion injury, are the most common... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Although most cases of chest pain are due to benign etiologies, such as gastroesophageal reflux or a muscle strain, life-threatening etiologies must be assessed and treated... Differential Diagnosis ... 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... 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... 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... 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... 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... 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... 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... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... Many patients presenting with pain in the foot or toes have joint disease (see pages 341 and 343 for a discussion of these differentials). Other anatomic components of the foot and toes
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... 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
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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
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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
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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
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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
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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
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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
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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 (
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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&
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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
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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.
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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
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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
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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
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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... History and physical examination ... Medical causes ... Special considerations ... 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... 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... History and physical examination ... Medical causes ... Special considerations ... Pictures
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... 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... 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... 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... 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,... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... 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),... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Although leg pain commonly signifies a musculoskeletal disorder, it can also result from a more serious vascular or neurologic disorder. The pain may arise suddenly or gradually and may be localized or affect the entire leg.... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... 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... 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,... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers
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... Throat pain — commonly known as a sore throat — refers to discomfort in any part of the pharynx: the nasopharynx, the oropharynx, or the hypopharynx. This common symptom ranges from a... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... Diffuse
Gastroenteritis
Peritonitis
Pancreatitis
Leukemia
Sickle cell crisis
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... Abdominal Disorders
Inflammatory disorders
Peritoneum
Peritonitis
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... Functional, mechanical causes: postural imbalance
Anteroposterior (e.g., pregnancy)
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... Skin and subcutaneous lesions [including adiposis dolorosa, thrombophlebitis of thoracoepigastric vein (Mondor's disease)]
Breast lesions
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... Chest Wall Disease
Bony thorax
Costochondritis (Tietze's syndrome)
Rib fracture or
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... Fracture
Contusion
Acromial-clavicular joint separation or injuries
Rotator cuff tendinitis or impingement syndrome
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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... 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... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
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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... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... 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... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... 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... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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Arm pain
(Professional Guide to Signs & Symptoms (Fifth Edition))
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... 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... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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Back pain
(Professional Guide to Signs & Symptoms (Fifth Edition))
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... 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... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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Chest pain
(Professional Guide to Signs & Symptoms (Fifth Edition))
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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... Emergency interventions ... History and physical examination ... 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). In this disorder, intense,... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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Flank pain
(Professional Guide to Signs & Symptoms (Fifth Edition))
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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... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Pictures
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Jaw pain
(Professional Guide to Signs & Symptoms (Fifth Edition))
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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),... Emergency Interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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Leg Pain
(Professional Guide to Signs & Symptoms (Fifth Edition))
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... Although leg pain commonly signifies a musculoskeletal disorder, it can also result from a more serious vascular or neurologic disorder. The pain may arise suddenly or gradually and may be localized or affect the entire leg.... Emergency Interventions ... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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Neck pain
(Professional Guide to Signs & Symptoms (Fifth Edition))
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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... 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... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling
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... Throat pain—commonly known as a sore throat—refers to discomfort in any part of the pharynx: the nasopharynx, the oropharynx, or the hypopharynx. This common symptom ranges from a... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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Chest Pain, Atypical
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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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... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
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Chest Pain, Substernal
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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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... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
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Low Back Pain
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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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:... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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Monarticular Joint Pain
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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... Margaret A. Tryforos
Approach Evaluation of monarticular joint pain should differentiate inflammatory from degenerative conditions and clarify... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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Abdominal Pain
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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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... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
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Calf Pain
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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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... History ... Physical examination (PE) ... Testing ... Diagnostic assessment ... Pictures
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Chronic Pelvic Pain
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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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... History ... Physical examination ... Testing (3) ... Diagnostic assessment
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Hip Pain
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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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... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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Knee Pain
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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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... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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Neck Pain
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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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... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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Pleuritic Pain
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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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... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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Scrotal Pain
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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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... History ... Physical examination ... Testing ... Diagnostic assessment
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Shoulder Pain
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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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... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment (3,4) ... Pictures
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... Differential Overview
❑ Irritable bowel syndrome
❑ Peptic ulcer disease
❑ Cholecystitis
❑ Chronic pancreatitis... Diagnostic Approach ... Clinical Findings
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... Differential Overview
❑ Costochondritis
❑ Pneumonia
❑ Rib fracture
❑ Pulmonary... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
❑ Chest wall pain
❑ Angina
❑ Unstable angina
❑ ... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
Ear Pain
❑ Acute otitis media
❑ Acute otitis externa ... Diagnostic Approach ... Clinical Findings
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... Differential Overview
❑ Maxillary sinusitis
❑ Dental infection
❑ Temporomandibular joint dysfunction ... 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
Pain Predominant
❑ Epididymitis
❑ Testicular torsion
❑ Prostatitis ... Diagnostic Approach ... Clinical Findings
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... Differential Overview
Generalized/Periumbilical
❑ Gastroenteritis
❑ Obstipation
❑ Small bowel obstruction ... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
❑ Osteoarthritis
❑ Patellofemoral pain
❑ Collateral ligament sprain
❑ Meniscal... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
Ankle Pain
❑ Ankle sprain
❑ Fibular fracture
❑ ... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
❑Lateral epicondylitis
❑Olecranon bursitis
❑Medial epicondylitis
&... Diagnostic Approach ... Clinical Findings
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... Differential Overview
❑ Conjunctivitis
❑ Corneal abrasion
❑ Foreign... Diagnostic Approach ... Clinical Findings
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... Differential Overview
❑ Ureteral calculus
❑ Acute pyelonephritis
❑ Latissimus strain
&... Diagnostic Approach ... Clinical Findings
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... Differential Overview
❑Hip osteoarthritis
❑Trochanteric bursitis
❑Ischial bursitis
... Diagnostic Approach ... Clinical Findings
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... Differential Overview
Posterior
❑ Musculoligamentous strain
❑ Cervical spondylosis
❑ Cervical... Diagnostic Approach ... Clinical Findings ... Pictures
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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 ... Causes ... Signs and symptoms ... Diagnostic tests ... Treatment ... Special considerations
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Abdominal pain
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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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... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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Back pain
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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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,... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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Chest pain
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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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... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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Eye pain
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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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... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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Flank pain
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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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... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
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Jaw pain
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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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... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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Neck pain
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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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... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Nursing considerations ... Patient teaching ... 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,... 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,... 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... 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. ... 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... 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... 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... 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... Emergency Actions ... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... 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... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... Although leg pain commonly signifies a musculoskeletal disorder, it can also result from a more serious vascular or neurologic disorder. The pain may arise suddenly or gradually and... Emergency Actions ... History ... Physical assessment ... Medical 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... 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... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Throat pain — also known as a sore throat — refers to discomfort in any part of the pharynx: the nasopharynx, the oropharynx, or the hypopharynx. This common symptom ranges from a... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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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... Principal Causes of Acute Abdominal Pain ... 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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Back Pain
(The Diagnostic Approach to Symptoms and Signs in Pediatrics)
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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 ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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Chest Pain
(The Diagnostic Approach to Symptoms and Signs in Pediatrics)
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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 ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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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... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching
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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... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... 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... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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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, page 52.)
In some cases, it may be referred... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
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... 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... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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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... History and physical examination ... 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... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching
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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... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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... Although leg pain commonly signifies a musculoskeletal disorder, it can also result from a more serious vascular or neurologic disorder. The pain may arise suddenly or gradually and may... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... 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... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... 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... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching
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... Throat pain—commonly known as a sore throat—refers to discomfort in any part of the pharynx: the nasopharynx, the oropharynx, or the hypopharynx. This common symptom ranges from a sensation of scratchiness to... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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...
Many patients presenting with pain in the foot or toes have joint
disease (see pages 284 and 286 for a discussion of these differentials). Other anatomic components ... Pictures
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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”... 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... 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... 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... 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... 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... 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... 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.
... 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,... 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.
... 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... 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... 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... Pictures
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...
Anatomy is the basic science that will open the door to this
differential diagnosis. Visualizing the structures in the hypogastrium, one
sees the abdominal wall, the bladder and urinary tract, the female... Pictures
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