Differential diagnosis: Definition, examples, and more

Differential diagnosis is a process wherein a doctor differentiates between two or more conditions that could be behind a person's symptoms. HealthConditionsHealthConditionsAlzheimer's&DementiaAnxietyArthritisAsthma&AllergiesBreastCancerCancerCardiovascularHealthCOVID-19Dermatology&SkincareDiabetesEnvironment&SustainabilityExercise&FitnessEyeHealthHeadache&MigraineHealthEquityHIV&AIDSHumanBiologyInflammatoryBowelDiseaseLeukemiaLGBTQIA+Men'sHealthMentalHealthMultipleSclerosis(MS)NutritionParkinson'sDiseasePsoriasisSexualHealthWomen'sHealthDiscoverNewsLatestNewsOriginalSeriesMedicalMythsHonestNutritionThroughMyEyesNewNormalHealthPodcastsHowtounderstandchronicpainWhatisbehindvaccinehesitancy?TheamazingstoryofhepatitisC,fromdiscoverytocureNewdirectionsindementiaresearchCanpsychedelicsrewireadepressed,anxiousbrain?WhyclimatechangemattersforhumanhealthToolsGeneralHealthDrugsA-ZHealthHubsHealthToolsBMICalculatorsandChartsBloodPressureChart:RangesandGuideBreastCancer:Self-ExaminationGuideSleepCalculatorHealthProductsAffordableTherapyOptionsBloodPressureMonitorsDiabeticSuppliesFitnessTrackersHomeGymsGreenCleaningProductsHowtoShopforCBDQuizzesRAMythsvsFactsType2Diabetes:ManagingBloodSugarAnkylosingSpondylitisPain:FactorFictionConnectAboutMedicalNewsTodayWhoWeAreOurEditorialProcessContentIntegrityConsciousLanguageNewslettersSignUpFollowUsMedicalNewsTodayHealthConditionsDiscoverToolsConnectSubscribeWhatisdifferentialdiagnosis?MedicallyreviewedbyStacySampson,D.O.—ByJesseKleinonJuly15,2020DefinitionStepsExamplesResultsSummaryDifferentialdiagnosisisaprocesswhereinadoctordifferentiatesbetweentwoormoreconditionsthatcouldbebehindaperson’ssymptoms.Whenmakingadiagnosis,adoctormayhaveasingletheoryastothecauseofaperson’ssymptoms.Theymaythenorderteststoconfirmtheirsuspecteddiagnosis.Often,however,thereisnosinglelaboratorytestthatcandefinitivelydiagnosethecauseofaperson’ssymptoms.Thisisbecausemanyconditionssharethesameorsimilarsymptoms,andsomepresentinavarietyofdifferentways.Tomakeadiagnosis,adoctormayneedtouseatechniquecalleddifferentialdiagnosis.Thisarticledescribeswhatdifferentialdiagnosisisandprovidessomeexamples.Itwillalsoexplainhowtointerprettheresultsofdifferentialdiagnosis.Whatisdifferentialdiagnosis?ShareonPinterestAdoctormayperformadifferentialdiagnosiswhenthereisnosinglelaboratorytesttodiagnosethecauseofaperson’ssymptoms.Differentialdiagnosisinvolvesmakingalistofpossibleconditionsthatcouldbecausingaperson’ssymptoms.Thedoctorwillbasethislistoninformationtheygainfrom:theperson’smedicalhistory,includingtheirself-reportedsymptomsphysicalexaminationfindingsdiagnostictestingLesscommonlyinthediagnosticapproach,adoctormayhaveonetheoryaboutthecauseofaperson’ssymptomsandtestforthatonecondition.However,manyconditionssharesomeofthesameorsimilarsymptoms.Thismakestheunderlyingconditiondifficulttodiagnoseusinganondifferentialdiagnosticapproach.Adifferentialdiagnosticapproachishelpfulwhentheremaybemultiplepotentialcausestoconsider.Thegoalsofdifferentialdiagnosisareto:narrowdowntheworkingdiagnosisguidemedicalevaluationandtreatmentruleoutlifethreateningortimecriticalconditionsenablethedoctortomakethecorrectdiagnosisWhatarethesteps?Differentialdiagnosiscantaketime.Foradoctortodeterminethecorrectdiagnosis,theywillfollowthestepsbelow.1.TakeamedicalhistoryWhenpreparingfordifferentialdiagnosis,adoctorwillneedtotakeaperson’sfullmedicalhistory.Somequestionstheymayaskinclude:Whatareyoursymptoms?Howlonghaveyoubeenexperiencingsymptoms?Doyouhaveafamilyhistoryofcertainconditions?Haveyoutraveledoutofthecountryrecently?Itisimportantthatapersonanswersallquestionshonestlyandinasmuchdetailaspossible.2.PerformaphysicalexamNext,adoctorwillwanttoperformabasicmedicalexamination.Theexaminationmayincludethefollowing:takingtheperson’sheartratetakingtheirbloodpressurelisteningtotheirlungsorexaminingotherareasofthebodyfromwhichsymptomsmaybeoriginating3.ConductdiagnostictestsAftertakingamedicalhistoryandperformingaphysicalexamination,thedoctormayhavesomeideasastowhatmaybecausingaperson’ssymptoms.Theymayorderoneormorediagnosticteststoruleoutcertainconditions.Suchtestsmayinclude:bloodtestsurinetestsdiagnosticimagingtests,suchas:ultrasoundscanX-rayMRIscanCTscanendoscopy4.SendthepersonforreferralsorconsultationsInsomecases,thedoctormayfeelthattheydonothavethespecificexpertisetodiagnosetheexactcauseofaperson’ssymptoms.Insuchcases,theymayreferthepersontoaspecialistforasecondopinion.Itisnotuncommonformultipledoctorstoreviewonepatientduringdifferentialdiagnosis.ExamplesofdifferentialdiagnosesBelowarethreeexamplesofcommondifferentialdiagnoses.ChestpainChestpainisasymptomthatcanhavemanycauses.Somearerelativelymild,whereasothersareseriousandrequireimmediatemedicalattention.Ifapersonisexperiencingchestpain,adoctorwillneedtoaskquestionstodeterminecertainfactors,suchasthelocation,severity,andfrequencyofthepain.Thesequestionsmayincludethefollowing:Howdoyoufeel?Describethesensation.Wheredoesithurt?Doesthepainextendtoanyotherpartofyourbody?Didanythingtriggerthepain?Howlonghasthepainlasted?Hasanythingmadethepainbetterorworse?Haveyouexperiencedanyothersymptoms?Byaskingthesequestions,thedoctorwillhopefullybeabletocategorizethechestpainasoneofthefollowingtypes:Cardiac:Theseconditionsrelatetotheheart.Examplesincludeunstableanginaandheartattack.Pulmonary:Theseconditionsrelatetothelungs.Examplesinclude:pulmonaryembolismpulmonaryhypertensionpneumoniaGastrointestinal:Theseconditionsrelatetothedigestivesystem.Examplesincludegastroesophagealrefluxdisease,whichcanleadtoBarrett’sesophagus,andpepticulcers.Musculoskeletal:Theseconditionsrelatetothemuscles,bones,andconnectivetissues.Examplesincludefracturedribsandothertraumatothechestwallorsternum.Miscellaneous:Thiscategorydescribesotherpotentialcausesofchestpain,suchas:anxietypanicattackslymphomaOncethedoctorhasnarroweddownthetypeofpain,theywillorderdiagnosticteststodeterminethepotentialcauseofthepain.Thesetestsmayinclude:electrocardiogram(EKG)echocardiogram(echo)endoscopyX-rayHeadachesHeadachesareacommonissue.Becauseofthis,itcanbedifficultforadoctortodeterminewhenaheadacheisabenignirritation,andwhenitisaserioushealthconcern.Duringdifferentialdiagnosis,adoctorwilllookforcertainredflagsthatindicatethattheheadacheismorethanjustaninconvenience.Theseredflagsincludethesuddenonsetofsevereheadacheandheadachefollowingheadtrauma.Thesuddenonsetofsevereheadachecouldindicateseveralunderlyingconditions,suchassubarachnoidhemorrhageorpituitaryapoplexy.Headachefollowingheadtraumacouldindicateintracranialhemorrhage,subduralhematoma,orepiduralhematoma.Thedoctorwillaskthefollowingquestionstodeterminewhetherornottheheadacheposesaseriousrisktotheperson’shealth:Didtheheadachestartgraduallyorsuddenly?Didanythingtriggertheheadache?Whereisthepain?Doesthepainseemtospreadtoanyotherarea?Ifso,where?Whatkindofpaindoyouhave?Isitthrobbing,stabbing,dull,orsomethingelse?Howbadisyourpain,onascaleof1to10?Doyouhaveheadachesregularly?Isthisyourfirstorworstheadache?Isthisheadacheliketheonesyouusuallyhave?Doyouhaveothersymptomsthatoccurwiththeheadache?Insomecases,thedoctormayperformaneurologicalexam.Thisexammayassessmultiplefactors,including:thepupils’responsestolightresponsestoorsensationoftouchdeeptendonreflexesmotorstrengthgaitAmedicalhistoryandphysicalexamcannarrowdownthepossiblecausesofheadache.NeuroimagingtestsusingCTorMRIscanscanhelpruleoutorconfirmcertaindiagnoses.StrokeStrokerequirespromptdiagnosisandtreatment.Becauseofthis,manydoctorsturntoadifferentialdiagnosticmethodwhenconsideringthepossibilityofastroke.Duringthephysicalexamination,adoctorwillcheckapersonforthefollowingsymptomsofastroke:confusionreducedmentalalertnessproblemswithcoordinationandbalanceproblemswithvisionnumbnessorweaknessoftheface,arms,orlegsdifficultyspeakingorcommunicatingThedoctorwilllookthroughaperson’smedicalhistorytoseeiftheyhaveanymedicalconditionsthatmayincreasetheirriskofstroke.Suchconditionsinclude:highbloodpressurehighcholesteroldiabetesatherosclerosis,includingcarotidarterydiseaseThedoctorwillthenorderoneormoreofthefollowingtests:bloodtestsaCTscan,tolookforpossiblebleedingonthebrainanMRIscan,tocheckthebraintissueforsignsofdamageanECGorEKG,tolookforheartproblemsthatcouldhavecausedastrokeHowtointerprettheresults Apersonmayrequiremultiplein-officeexaminationsanddiagnostictestsbeforetheyreceiveadefinitivediagnosis.Somepatientsmayhavemultiplenegativetestresultsbeforetheygetadiagnosis.However,eachnegativetestresultbringsthedoctoronestepclosertofiguringoutthecauseofaperson’ssymptoms.Somepeoplemayneedtobegintreatmentbeforeadoctorhasconfirmedtheirdiagnosis.Thismaybethecaseifoneofthepotentialcausesofaperson’ssymptomsrequiresprompttreatmenttopreventfurthercomplications.Aperson’sresponsetoaparticulartreatmentcanitselfprovidevaluableinsightsintothecauseoftheirsymptoms.SummaryDifferentialdiagnosisreferstoalistofpossibleconditionsthatmaybecausingaperson’ssymptoms.Adoctorwillbasethislistonseveralfactors,includingaperson’smedicalhistoryandtheresultsofanyphysicalexaminationsanddiagnostictests.Manyconditionssharethesamesymptoms.Thiscanmakecertainconditionsdifficulttodiagnoseusinganondifferentialdiagnosticapproach.Adifferentialdiagnosticapproachmaybenecessaryincaseswherethereismorethanonepotentialcauseofaperson’ssymptoms.Undergoingdifferentialdiagnosiscanbealong,worrying,andfrustratingprocess.However,itisarationalandsystematicapproachthatcanallowadoctortocorrectlypinpointtheunderlyingcauseofaperson’ssymptoms.LastmedicallyreviewedonJuly15,2020MedicalDevices/DiagnosticsPrimaryCareHowwevettedthisarticle:SourcesMedicalNewsTodayhasstrictsourcingguidelinesanddrawsonlyfrompeer-reviewedstudies,academicresearchinstitutions,andmedicaljournalsandassociations.Weavoidusingtertiaryreferences.Welinkprimarysources—includingstudies,scientificreferences,andstatistics—withineacharticleandalsolistthemintheresourcessectionatthebottomofourarticles.Youcanlearnmoreabouthowweensureourcontentisaccurateandcurrentbyreadingoureditorialpolicy.Balogh,E.P.,etal.(2015).Chapter2:Thediagnosticprocess.ImprovingDiagnosisinHealthCare.Washington,DC:TheNationalAcademiesPress.https://www.nap.edu/read/21794/chapter/4Causes:Stroke.(2019).https://www.nhs.uk/conditions/stroke/causes/Clinch,C.R.(2001).Evaluationofacuteheadachesinadults.https://www.aafp.org/afp/2001/0215/p685.htmlDiagnosis–Stroke–Diagnosis.(n.d.).https://www.nhlbi.nih.gov/node/3849Differentialdiagnosis.(2020).https://medlineplus.gov/lab-tests/differential-diagnosis/Digestivediseases.(n.d.).https://www.niddk.nih.gov/health-information/digestive-diseasesPneumoniarecoveryandtreatment.(2020).http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/pneumonia/diagnosing-and-treating.htmlWaldmanZ.,&Ottolini,M.(n.d.).Differentialdiagnosis:Approachesandpitfalls.https://hsrc.himmelfarb.gwu.edu/cgi/viewcontent.cgi?article=1021&context=elearningSharethisarticleMedicallyreviewedbyStacySampson,D.O.—ByJesseKleinonJuly15,2020LatestnewsPainnervesmayhelptomaintainahealthygut,studyshowsSkinandbraincancers:NewdiscoverymayhelpimprovetreatmentType2diabetesdrugmayhelplowerdementiariskby22%Willitbepossibletotreatinheritedblindnessinadults?CanwhereyouliveaffectyourPCOSsymptoms?RelatedCoverageAllaboutbloodtestsMedicallyreviewedbyStacySampson,D.O.Bloodtestsarecommonlypartofroutinepreventativecareanddiagnostics.Learnaboutthedifferenttypesofbloodtestsandwhattheymeanhere.READMOREEverythingyouneedtoknowabouturinalysisMedicallyreviewedbyCarissaStephens,RN,CCRN,CPNUrinalysis,oraurinetest,canhelpadoctordiagnosecertainhealthissues,checkforpregnancy,orscreenfordruguse.Inthisarticle,learn…READMOREWhattoknowaboutMRIscansMedicallyreviewedbyJudithMarcin,M.D.Magneticresonanceimaging(MRI)scansproducedetailedimagesoftheorgansandtissuesinthebody.UnlikeCTscansandX-rays,anMRIdoesnotuse…READMOREHowdoesaCTorCATscanwork?MedicallyreviewedbySeungguHan,MDComputedtomography(CT),otherwiseknownascomputedaxialtomography(CAT)scans,givedoctorsexplicitinternalimagesofthebody,whichtheycan…READMOREWhattoknowaboutX-raysMedicallyreviewedbyWilliamMorrison,M.D.X-raysmayposeasmallcancerrisk,buttheirbenefitsfaroutweightheirrisks,andtheyfrequentlysavelives.Thisarticleexplainseverything…READMORE