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General Pathology 601 for Dental Students 601 Home | Syllabus | Differential Diagnosis General Principles of A Differential Diagnosis A differential diagnosis refers to a list of possible causes for a patient's problem. It involves a process of including, excluding and prioritizing possibilities. To illustrate the process, consider the steps you'd take if a patient tells you she has a mass inside her cheek. You need to prove in the best way possible, what that mass is. Applying the differential diagnosis technique, you'd first develop a list of possible causes for that mass. By obtaining a history from the patient and examining the mass, you'd narrow or prioritize your list of possible causes. Prioritizing means to list the possibilities from the most likely to the least likely. This is done through physical examination and various tests. Many people use various terms for a differential diagnosis. Occasionally, the terms "working diagnosis" or "hypothesis" are used. These terms suggest a process for determining "the most likely" diagnosis for that condition. By doing specific examinations (x-rays and lab tests) one can rule in (include) or rule out (exclude) some of the choices on your list of diagnoses. What does it mean when the doctor asks for signs and symptoms of a patient's presenting problem? A sign is any abnormality indicative of disease which is discovered by the physician at physical examination. It is an objective finding, a factual item. On the other hand, a symptom is a subjective finding described by the patient. For example, a patient may complain of feeling tired and lethargic. These are symptoms described by the patient. Signs include pale skin and conjunctiva from an underlying anemia. You may deduce that anemia is a possible cause of the problem, since anemia can cause one to feel tired and lethargic. You will add anemia to your list of possible causes. As you progress through these laboratory cases, you will learn to refine your differential diagnoses and become more efficient in determining the problems.
Updated April 29, 2008
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