The term diagnosis of exclusion (per exclusionem) refers to a medical condition whose presence cannot be established with complete confidence from examination or testing. Diagnosis is therefore by elimination of other reasonable possibilities.
Perhaps the largest category of diagnosis by exclusion is seen among psychiatric disorders where the presence of physical or organic disease must be excluded as a pre-requisite for making a functional diagnosis. Diagnosis by exclusion tends to occur where scientific knowledge is scarce, specifically where the means to verify a diagnosis by an objective method is absent. As a specific diagnosis cannot be confirmed a fall back position is to exclude that group of known causes that may cause a similar clinical presentation.
Examples
An example of such a diagnosis is "fever of unknown origin": to explain the cause of elevated temperature the most common causes of unexplained fever (infection, neoplasm, or collagen vascular disease) must be ruled out.
Other examples include:
- Behcet's Disease[1]
- Bell's Palsy[2]
- Sarcoidosis[3]
- Tolosa-Hunt syndrome[4]
- Irritable bowel syndrome[5][6]
See also
References
- ^ "Behcet Disease: Overview - eMedicine Dermatology". http://emedicine.medscape.com/article/1122381-overview. Retrieved 2009-03-28.
- ^ Petruzzelli GJ, Hirsch BE (August 1991). "Bell's palsy. A diagnosis of exclusion". Postgrad Med 90 (2): 115–8, 121–2, 125–7. PMID 1862038.
- ^ "What is Sarcoidosis?, What is Sarcoidosis?". http://www.musc.edu/sarcoidosis/what_is_sarcoid.htm.
- ^ Kwan ES, Wolpert SM, Hedges TR, Laucella M (February 1988). "Tolosa-Hunt syndrome revisited: not necessarily a diagnosis of exclusion". AJR Am J Roentgenol 150 (2): 413–8. PMID 3257334. http://www.ajronline.org/cgi/pmidlookup?view=long&pmid=3257334.
- ^ Cash BD, Chey WD (June 2004). "Irritable bowel syndrome - an evidence-based approach to diagnosis". Aliment. Pharmacol. Ther. 19 (12): 1235–45. doi:. PMID 15191504. http://www.blackwell-synergy.com/openurl?genre=article&sid=nlm:pubmed&issn=0269-2813&date=2004&volume=19&issue=12&spage=1235.
- ^ Cash BD, Chey WD (December 2003). "Advances in the management of irritable bowel syndrome". Curr Gastroenterol Rep 5 (6): 468–75. PMID 14602054.
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