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<span>Differential Diagnosis</span>
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<h1>Differential Diagnosis</h1>
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<section><div class="mp-content"><h2>What is a differential diagnosis?</h2>
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<p>Different health conditions often cause similar symptoms. For example, <a data-tid="5324" href="https://medlineplus.gov/fatigue.html">fatigue</a> is a symptom that can be caused by <a data-tid="139" href="https://medlineplus.gov/anemia.html">anemia</a>, <a data-tid="113" href="https://medlineplus.gov/depression.html">depression</a>, <a data-tid="277" href="https://medlineplus.gov/heartdiseases.html">heart disease</a>, <a data-tid="439" href="https://medlineplus.gov/thyroiddiseases.html">thyroid disease</a>, <a data-tid="408" href="https://medlineplus.gov/sleepdisorders.html">sleep disorders</a>, and many other conditions. If you have fatigue or other symptoms that are linked to many conditions, your provider has to figure out which condition you have so that you get the right treatment.</p>
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<p>To make a diagnosis, your provider will follow a careful step-by-step process of ruling out conditions that share your symptoms until it's clear which condition is most likely the cause of your illness. This process is called making a differential diagnosis.</p>
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<p>An important step in making a differential diagnosis is to make a list of all the <em>possible</em> conditions that you <em>might</em> have. This is your differential diagnosis list. Your provider will base your list on your specific:</p>
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<ul>
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<li>Symptoms</li>
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<li>Medical history</li>
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<li>Family health history</li>
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<li>Test results</li>
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</ul>
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<p>A list of possible conditions helps your provider decide which tests will help confirm or rule out the conditions that could be causing your symptoms. Your test results help narrow your differential diagnosis list until it's clear which condition you have. This is your final diagnosis.</p>
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<p>The process of making a differential diagnosis may take time, but it helps make sure your provider doesn't miss a possible cause of your symptoms. That means your final diagnosis is more likely to be accurate and you'll get the right treatment.</p></div>
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</section>
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<section><div class="mp-content"><h2>How is it used?</h2>
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<p>A differential diagnosis process is used to help make a final diagnosis when you have symptoms that don't have one clear cause. It can be used to help diagnose physical and <a data-tid="5676" href="https://medlineplus.gov/mentaldisorders.html">mental disorders</a>.</p></div>
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</section>
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<section><div class="mp-content"><h2>What happens during a differential diagnosis?</h2>
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<p>To make a differential diagnosis, your provider has to think like a detective and follow several steps:</p>
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<p><strong>The first step is to gather clues by asking you about your health.</strong></p>
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<p>Your provider will ask detailed questions about your:</p>
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<ul>
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<li><strong>Symptoms</strong>, such as:
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<ul>
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<li>How do your symptoms feel and how do they affect you?</li>
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<li>When did they start and how long do they last?</li>
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<li>What makes them better or worse?</li>
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</ul>
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</li>
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<li><strong>Medical history.</strong> Your provider will consider whether your symptoms could be related to health problems you already have.</li>
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<li><strong>Medicines and supplements.</strong> Sometimes symptoms can be side effects from medicines or supplements, so your provider will want to know about anything you take.</li>
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<li><strong>Family health history.</strong> If a certain condition <a data-pid="20159" href="https://medlineplus.gov/genetics/understanding/inheritance/runsinfamily/">runs in your family</a>, your provider will consider whether your symptoms are a sign of that condition.</li>
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<li><strong>Life and habits.</strong> Changes or problems with your sleep, diet, exercise, work, mood, and relationships can be causes or symptoms of many conditions.</li>
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</ul>
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<p><strong>The second step of the differential diagnosis process is a physical exam.</strong> Information from an exam gives your provider more clues about your health. It may help rule out certain conditions or make others seem more likely.</p>
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<p><strong>The third step is to put together a differential diagnosis list.</strong> Your provider will come up with a list of "suspects" -- the conditions that you <em>may</em> have based on information about your symptoms, health, and lifestyle.</p>
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<p><strong>The fourth step is to order tests.</strong> Tests can help confirm or rule out the conditions on your differential diagnosis list. The tests you have will depend on the conditions on your list. If your list includes a serious condition that may need urgent treatment, you'll have tests for that condition first.</p>
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<p>Common tests to help narrow your differential diagnosis list may include:</p>
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<ul>
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<li>Lab tests, such as blood and <a data-tid="6355" href="https://medlineplus.gov/urinalysis.html">urine (pee) tests</a></li>
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<li>A <a data-tid="5921" href="https://medlineplus.gov/biopsy.html">biopsy</a></li>
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<li><a data-tid="1104" href="https://medlineplus.gov/diagnosticimaging.html">Imaging tests</a>, such as an <a data-tid="3953" href="https://medlineplus.gov/mriscans.html">MRI scan</a>, <a data-pid="3501" href="https://medlineplus.gov/lab-tests/sonogram/">ultrasound</a>, or <a data-tid="3949" href="https://medlineplus.gov/xrays.html">x-ray</a></li>
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<li>A <a data-pid="2157" href="https://medlineplus.gov/lab-tests/mental-health-screening/">mental health screening</a> if your symptoms could be caused by a mental disorder</li>
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</ul>
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<p>As test results rule out some of the possible causes of your symptoms, your final diagnosis should become clear. Then your provider can recommend treatment.</p></div>
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</section>
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<section><div class="mp-content"><h2>What do my results mean?</h2>
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<p>The conditions on your differential diagnosis list are <em>not</em> your final diagnosis. They're the conditions that <em>could</em> cause symptoms like yours. If you have questions about these conditions, talk with your provider.</p>
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<p>Your provider will use the differential diagnosis list to choose which tests to order. Each time you get test results, ask your provider how they affect your differential diagnosis. Test results may help your provider decide to do other tests, or they may guide treatment choices.</p>
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<p>Learn more about <a data-pid="806" href="https://medlineplus.gov/lab-tests/how-to-understand-your-lab-results/">laboratory tests, reference ranges, and understanding results</a>.</p></div>
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</section>
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<section><div class="mp-content"><h2>Is there anything else I need to know about a differential diagnosis?</h2>
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<p>Your provider may recommend starting treatment before your final diagnosis is certain. That's because the goal of making a differential diagnosis is to narrow the possible causes of your symptoms until your provider can figure out which treatments are most likely to help you.</p>
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<p>In certain cases, your provider may learn more about your condition by seeing whether or not a treatment improves your symptoms. That information may help lead to a final diagnosis.</p></div>
|
||
</section>
|
||
|
||
<section><div class="mp-refs mp-content"><h2>References</h2>
|
||
<ol>
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||
<li>Bosner F, Pickert J, Stibane T. Teaching differential diagnosis in primary care using an inverted classroom approach: student satisfaction and gain in skills and knowledge. BMC Med Educ [Internet]. 2015 Apr 1 [cited 2022 Oct 17]; 15: 63. Available from: <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4404043/?report=classic" target="bibliowin">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4404043/?report=classic</a></li>
|
||
<li>Canadian Medical Protective Association. [Internet]. Ottawa (Ontario): Clinical Decision-Making; [2021 March; cited 2022 Oct17]; [about 3 screens]. Available from: <a href="https://www.cmpa-acpm.ca/en/education-events/good-practices/physician-patient/clinical-decision-making" target="bibliowin">https://www.cmpa-acpm.ca/en/education-events/good-practices/physician-patient/clinical-decision-making</a></li>
|
||
<li>Cleveland Clinic: Health Library: Diagnostics & Testing [Internet]. Cleveland (OH): Cleveland Clinic; c2022. Differential Diagnosis; [reviewed 2022 Jan 27; cited 2022 Oct 17]; [about 13 screens]. Available from: <a href="https://my.clevelandclinic.org/health/diagnostics/22327-differential-diagnosis" target="bibliowin">https://my.clevelandclinic.org/health/diagnostics/22327-differential-diagnosis</a></li>
|
||
<li>Ely JW, Stone MS. The Generalized Rash: Part I. Differential Diagnosis. Am Fam Physician [Internet]. 2010 Mar 15 [cited 2022 Oct 17]; 81 (6):726–734. Available from: <a href="https://www.aafp.org/afp/2010/0315/p726.html" target="bibliowin">https://www.aafp.org/afp/2010/0315/p726.html</a></li>
|
||
<li>Endometriosis.net [Internet]. Philadelphia: Health Union; c2022. Differential Diagnosis: Health Conditions with Similar Symptoms to Endometriosis; [updated 2021 Feb; cited 2022 Oct 17]; [about 4 screens]. Available from: <a href="https://endometriosis.net/diagnosis/exclusion" target="bibliowin">https://endometriosis.net/diagnosis/exclusion</a></li>
|
||
<li>Committee on Diagnostic Error in Health Care; Board on Health Care Services; Institute of Medicine; The National Academies of Sciences, Engineering, and Medicine; Balogh EP, Miller BT, Ball JR, editors. Improving Diagnosis in Health Care. Washington (DC): National Academies Press (US); 2015 Dec 29.[cited 2022 Oct 17] 2, The Diagnostic Process. Available from: <a href="https://www.ncbi.nlm.nih.gov/books/NBK338593/" target="bibliowin">https://www.ncbi.nlm.nih.gov/books/NBK338593/</a></li>
|
||
<li>Epstein H. Ask these key questions when you get a diagnosis. Society to Improve Diagnosis in Medicine; c2022. [Internet]. [cited 2022 Oct 17]; [about 21 screens]. Available from: <a href="https://www.improvediagnosis.org/dxiq-column/ask-these-key-questions-when-you-get-a-diagnosis/" target="bibliowin">https://www.improvediagnosis.org/dxiq-column/ask-these-key-questions-when-you-get-a-diagnosis/</a></li>
|
||
<li>JEMS: Journal of Emergency Medical Services [Internet]. Tulsa (OK): PennWell Corporation; c2022. Differential Diagnoses are Important for Patient Outcome; 2016 Feb 29 [cited 2022 Oct 17]; [about 3 screens]. Available from: <a href="https://www.jems.com/patient-care/differential-diagnoses-are-important-for-patient-outcome/" target="bibliowin">https://www.jems.com/patient-care/differential-diagnoses-are-important-for-patient-outcome/</a></li>
|
||
<li>National Institute on Aging [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Obtaining an Older Patient's Medical History; [updated 2017 May 17; cited 2022 Oct 17]; [about 3 screens]. Available from: <a href="https://www.nia.nih.gov/health/obtaining-older-patients-medical-history" target="bibliowin">https://www.nia.nih.gov/health/obtaining-older-patients-medical-history</a></li>
|
||
<li>Richardson SW, Glasziou PG, Polashenski WA, Wilson MC. A new arrival: evidence about differential diagnosis. BMJ [Internet]. 2000 Nov [cited 2022 Oct 17]; 5 (6):164–165. Available from: <a href="https://ebm.bmj.com/content/5/6/164" target="bibliowin">https://ebm.bmj.com/content/5/6/164</a></li>
|
||
<li>Science Direct [Internet]. Elsevier B.V.; c2022. Differential diagnosis; [cited 2022 Oct 17]; [about 2 screens]. Available from: <a href="https://www.sciencedirect.com/topics/neuroscience/differential-diagnosis" target="bibliowin">https://www.sciencedirect.com/topics/neuroscience/differential-diagnosis</a></li>
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