Less life threatening differential diagnoses

robert bell rmsbell200 at YAHOO.COM
Sun Aug 2 03:14:06 UTC 2015


Thanks Carmel,

Yes, I should have thought about eye and ear.

Do we know a lot about ear, eye, rib and abdominal pain in terms of distribution, type, onset before lesions, and aggravating and ameliorating factors in the eventual distribution of the lesions?

Has that been studied well?  If we knew more would it help?

Rob Bell
> On Aug 1, 2015, at 6:55 PM, Carmel Crock <Carmel.Crock at eyeandear.org.au> wrote:
> 
> Dear Rob
> I thought I would mention that at our Eye and ENT hospital emergency department, shingles is one of our commonest missed or delayed diagnosis, as patients present early with severe eye or ear pain but nothing (or little) to show on clinical examination.
> Regards
> Carmel Crock
> From: robert bell [0000000296e45ec4-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG <mailto:0000000296e45ec4-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG>]
> Sent: Sunday, 2 August 2015 9:08 AM
> To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
> Subject: [IMPROVEDX] Less life threatening differential diagnoses
> 
> To me it seems that despite frequency patterns medical students are rightly taught at great length to focus on not missing the life threatening diagnosis. Is this done at the expense of missing the diagnosis with less dangerous competing conditions that are on the differential diagnostic list.
> 
> For example, how much do most medical students/residents know about shingles pain and symptoms prior to lesion development, with any lack of knowledge leading to the “diagnosis” of possible acute abdomen?
> 
> I would argue that in training knowing FAR more about the less dangerous differential diagnoses would get us more quickly to an accurate diagnosis, at possibly lesser cost.
> 
> So should there be in training more focus on the less serious competing differential diagnoses? 
> 
> Rob Bell
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Robert M. Bell, M.D., Ph.C.
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Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


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