A diagnosis of exclusion or by exclusion (per exclusionem) is a diagnosis of a medical condition reached by a process of elimination, which may be necessary if presence cannot be established with complete confidence from history, examination or testing. Such elimination of other reasonable possibilities is a major component in performing a differential 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.
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 prerequisite for making a functional diagnosis.
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.
^Petruzzelli GJ, Hirsch BE (August 1991). "Bell's palsy. A diagnosis of exclusion". Postgraduate Medicine. 90 (2): 115–118, 121–122, 125–127. doi:10.1080/00325481.1991.11701011. PMID 1862038.
^Maltsman-Tseikhin A, Moricca P, Niv D (June 2007). "Burning mouth syndrome: will better understanding yield better management?". Pain Practice. 7 (2): 151–162. doi:10.1111/j.1533-2500.2007.00124.x. PMID 17559486. S2CID 4820793.
^Ferguson B, Gryfe D, Hsu W (December 2013). "Chronic recurrent multifocal osteomyelitis in a 13 year old female athlete: a case report". The Journal of the Canadian Chiropractic Association. 57 (4): 334–340. PMC3845477. PMID 24302781.
^Leviner, Sherry (7 May 2021). "Recognizing the Clinical Sequelae of COVID-19 in Adults: COVID-19 Long-Haulers". The Journal for Nurse Practitioners. 17 (8): 946–949. doi:10.1016/j.nurpra.2021.05.003. ISSN 1555-4155. PMC8103144. PMID 33976591.
^Prince, Jim McMorran, Damian Crowther, Stew McMorran, Steve Youngmin, Ian Wacogne, Jon Pleat, Clive. "primary polydipsia – General Practice Notebook". www.gpnotebook.co.uk. Retrieved 2016-11-22.
^Freudenreich, O (December 2012). "Differential Diagnosis of Psychotic Symptoms: Medical 'Mimics'". Psychiatric Times.
^Henningsen, Peter (March 2018). "Management of somatic symptom disorder". Dialogues in Clinical Neuroscience. 20 (1): 23–31. doi:10.31887/DCNS.2018.20.1/phenningsen. ISSN 1294-8322. PMC6016049. PMID 29946208.
^Kwan ES, Wolpert SM, Hedges TR, Laucella M (February 1988). "Tolosa-Hunt syndrome revisited: not necessarily a diagnosis of exclusion". AJR. American Journal of Roentgenology. 150 (2): 413–418. doi:10.2214/ajr.150.2.413. PMID 3257334.
January 07, 2023
diagnosis, exclusion, diagnosis, exclusion, exclusion, exclusionem, diagnosis, medical, condition, reached, process, elimination, which, necessary, presence, cannot, established, with, complete, confidence, from, history, examination, testing, such, eliminatio. A diagnosis of exclusion or by exclusion per exclusionem is a diagnosis of a medical condition reached by a process of elimination which may be necessary if presence cannot be established with complete confidence from history examination or testing Such elimination of other reasonable possibilities is a major component in performing a differential 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 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 prerequisite for making a functional diagnosis Examples EditAn 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 Adult onset Still s disease 1 Behcet s disease 2 Bell s palsy 3 Burning mouth syndrome 4 Chronic recurrent multifocal osteomyelitis 5 Long COVID 6 Psychogenic polydipsia 7 Schizophrenia 8 Somatic symptom disorder 9 Sudden infant death syndrome medical citation needed Tolosa Hunt syndrome 10 See also EditIdiopathicReferences Edit Akkara Veetil BM Yee AH Warrington KJ Aksamit AJ Jr Mason TG December 2012 Aseptic meningitis in adult onset Still s disease Rheumatol Int 32 12 4031 4034 doi 10 1007 s00296 010 1529 8 PMID 20495923 S2CID 19431424 Behcet Disease Overview eMedicine Dermatology Retrieved 2009 03 28 Petruzzelli GJ Hirsch BE August 1991 Bell s palsy A diagnosis of exclusion Postgraduate Medicine 90 2 115 118 121 122 125 127 doi 10 1080 00325481 1991 11701011 PMID 1862038 Maltsman Tseikhin A Moricca P Niv D June 2007 Burning mouth syndrome will better understanding yield better management Pain Practice 7 2 151 162 doi 10 1111 j 1533 2500 2007 00124 x PMID 17559486 S2CID 4820793 Ferguson B Gryfe D Hsu W December 2013 Chronic recurrent multifocal osteomyelitis in a 13 year old female athlete a case report The Journal of the Canadian Chiropractic Association 57 4 334 340 PMC 3845477 PMID 24302781 Leviner Sherry 7 May 2021 Recognizing the Clinical Sequelae of COVID 19 in Adults COVID 19 Long Haulers The Journal for Nurse Practitioners 17 8 946 949 doi 10 1016 j nurpra 2021 05 003 ISSN 1555 4155 PMC 8103144 PMID 33976591 Prince Jim McMorran Damian Crowther Stew McMorran Steve Youngmin Ian Wacogne Jon Pleat Clive primary polydipsia General Practice Notebook www gpnotebook co uk Retrieved 2016 11 22 Freudenreich O December 2012 Differential Diagnosis of Psychotic Symptoms Medical Mimics Psychiatric Times Henningsen Peter March 2018 Management of somatic symptom disorder Dialogues in Clinical Neuroscience 20 1 23 31 doi 10 31887 DCNS 2018 20 1 phenningsen ISSN 1294 8322 PMC 6016049 PMID 29946208 Kwan ES Wolpert SM Hedges TR Laucella M February 1988 Tolosa Hunt syndrome revisited not necessarily a diagnosis of exclusion AJR American Journal of Roentgenology 150 2 413 418 doi 10 2214 ajr 150 2 413 PMID 3257334 Retrieved from https en wikipedia org w index php title Diagnosis of exclusion amp oldid 1115723079, wikipedia, wiki, book, books, library,
