Diagnosis of exclusion

Diagnosis of exclusion

A diagnosis of exclusion (per exclusionem) is a medical condition reached by a process of elimination, which may be necessary if presence cannot be established with complete confidence from examination or testing. Such elimination of other reasonable possibilities is a major component in performing a differential diagnosis.

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:

See also

References

  1. ^ "Behcet Disease: Overview - eMedicine Dermatology". http://emedicine.medscape.com/article/1122381-overview. Retrieved 2009-03-28. 
  2. ^ 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. 
  3. ^ "What is Sarcoidosis?, What is Sarcoidosis?". http://www.musc.edu/sarcoidosis/what_is_sarcoid.htm. 
  4. ^ 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. 
  5. ^ Cash BD, Chey WD (June 2004). "Irritable bowel syndrome - an evidence-based approach to diagnosis". Aliment. Pharmacol. Ther. 19 (12): 1235–45. doi:10.1111/j.1365-2036.2004.02001.x. PMID 15191504. http://www.blackwell-synergy.com/openurl?genre=article&sid=nlm:pubmed&issn=0269-2813&date=2004&volume=19&issue=12&spage=1235. 
  6. ^ Cash BD, Chey WD (December 2003). "Advances in the management of irritable bowel syndrome". Curr Gastroenterol Rep 5 (6): 468–75. doi:10.1007/s11894-003-0035-5. PMID 14602054. 

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