Review Of Differential Diagnosis Research Articles

Low back pain- Algorithm of diagnosis and management

Abstract: Introduction: Low back pain is a frequent condition, associated as a symptom with a multitude of organic or non-organic pathologies, resulting in the appearance of disability gener-ating negative economic and soc-professional consequences. Being a relatively common symptom among patients, we created this paper with the aim to high-light the importance of the clinical examination along with the correct direction of the patient to a profile depart-ment, the review of differential diagnoses, as well as the establishment of a particular recovery plan adapted to each case. Materials and Methods: We analyzed a series of recent articles using the PubMed and the Cochrane Library data-bases ,using the keywords words “low back pain” and “rehabilitation”, to obtain data on the clinical and paraclinical examination, positive and differential diagnosis of chronic low back pain, as well as on rehabilitation management. Results: Low back pain may appear due to vertebral conditions (inflammatory, infectious, trau-matic, neoplastic, degenerative, metabolic), or due to extravertebral causes. Along with the an-amnesis, clinical examination and im-agistic investigations, we establish the positive diagnosis and create an individualised rehabilitation plan. The reha-bilitation protocol is divided into stages , the final goal is to minimize the ischemia-pain-contracture chain. Conclusion: The pathology of the lumbosacral spine can be characterized by the word "diversity", being one of the causes of early disability of the population in the field of work. Our work highlights the importance of the clinical and paraclinical examination in outlining the differential diagnosis of chronic lumbar pain, as well as the role of the multidisciplinary team in complex individualized rehabilitation treatment.

Cyclic Vomiting Syndrome: Case Report and Review of Differential Diagnoses

Cyclic Vomiting Syndrome: Case Report and Review of Differential Diagnoses

Plasmacytoma of the larynx: case report and literature review of laryngeal extra-medullary plasmacytoma

BackgroundMonoclonal plasma cell neoplasms are rare; laryngeal solitary plasmacytoma is very rare.Case presentationThis is the case of a 46-year-old man who has been treated for chronic laryngitis for 8 months; he presented first with dysphonia, dyspnea, and dysphagia. The initial tests showed normal erythrocyte counts, elevated erythrocyte sedimentation rates, elevated CRP, and a thrombocytopenia at 40.000. The rest of the test panel was without incidence. Whole body MRI was performed which showed no additional lesion besides the laryngeal location. Bone marrow biopsy was normal. The patient underwent pan-endoscopy under general anesthesia. The biopsy result showed plasmacytoma. The patient had radiotherapy, after which the patient needed tracheotomy with a good outcome. This work presents a very rare case of laryngeal solitary plasmacytoma, with a literature review of differential diagnosis, as well as current trends in diagnosis, and therapy.ConclusionThe essential take-home message is that however, this is a rare entity, it should be considered and treated as a malignant disease that could progress to diseases with worse diagnoses. Timely diagnosis and treatment can allow good outcomes and prevention of progression.

Prenatal findings of cataract and arthrogryposis: recurrence of cerebro-oculo-facio-skeletal syndrome and review of differential diagnosis

BackgroundCerebro-oculo-facio-skeletal syndrome (COFS) is a severe and progressive neurologic condition characterized by prenatal onset of arthrogryposis, cataract, microcephaly and growth failure. The aim of this study was to present a case of recurrence of the COFS syndrome and to propose a differential diagnosis flow-chart in case of prenatal findings of arthrogryposis and cataract.Case presentationWe report a case of recurrence of COFS3 syndrome within the same family, with similar diagnostic features. In the first case the COFS syndrome remained undiagnosed, while in the second case, due to prenatal findings of arthrogryposis and cataract, genetic investigation focusing on responsible genes of COFS (ERCC5, ERCC6 and FKTN genes) was carried out. The fetus was found to be compound heterozygous for two different ERCC5 mutations, confirming the clinical suspect of COFS syndrome. A review of the literature on possible causative genes of prenatal cataract and arthrogryposis was performed and we present a flow-chart to guide differential diagnosis and possible genetic testing in case of these findings.ConclusionCOFS syndrome is a rare autosomic recessive condition. However, it can be suspected and diagnosed prenatally. The flow-chart illustrates a pathway to guide differential diagnosis according to the prenatal findings. Main syndromes, key testing and specific genes are included. Targeted molecular testing should be offered to the couple in order to reach a diagnosis and assess the recurrence risk for future pregnancies.

Performance and rideability issues in horses as a manifestation of pain: A review of differential diagnosis and diagnostic approach

SummaryNonspecific performance and rideability issues are more likely a manifestation of pain in the ridden horse rather than a true behavioural problem. A systematic and thorough investigation focusing on the potential presence of pain‐related conditions is thus crucial in horses with such complaints. It can, however, be challenging to determine whether the complaint is indeed related to pain, where the pain is located, and what the underlying cause is. This review describes the challenges of pain recognition in ridden horses and summarises the recently developed ridden horse ethograms that might enable pain to be assessed in an objective, valid and reliable way. Furthermore, the differential diagnosis and diagnostic approach to horses presenting potentially pain‐related performance and rideability issues are discussed.

Chronic Pelvic Pain in Women with a History of Essure Placement: A Systematic Review of Differential Diagnosis and Management Options

Study Objective The purpose of this article is to provide an evidence based review of management options for patients with pelvic pain and an in situ Essure device. Design Literature review and qualitative analysis. Setting N/A Patients or Participants N/A Interventions N/A Measurements and Main Results The Essure device was voluntarily withdrawn from the market in 2018 by the manufacturer due in part to concerns about post placement adverse events and an FDA black box warning about uterine and fallopian tube perforation, suspected allergic or hypersensitivity reaction, and need for surgical removal for adverse events which were mostly related to pain. We performed a PubMed keyword literature search, as well as directed searches of Obstetrics & Gynecology, American Journal of Obstetrics and Gynecology, and Journal of Minimally Invasive Gynecology. A total of 43 publications were included, and consisted of 7 prospective studies, 15 retrospective studies, 18 case series, 2 review articles, and one summary article by the FDA. Conclusion A brief summary of recommendations and conclusions from this review: - Initial work up of pain in a patient with Essure devices should begin with placement confirmation via either transvaginal ultrasound or hysterosalpingogram/Xray. - In the event Essure microinserts are malpositioned, device removal is recommended. - In patients with a history and physical exam suggestive of possible endometriosis or adenomyosis, consider an attempt at hormonal management prior to surgical excision of the Essure device. - We recommend a laparoscopic resection of the fallopian tubes with or without partial coronuectomy for the management of pelvic pain of and no other identifiable source, even if Essure device is positioned appropriately. - We recommend an imaging modality be available in the OR during device removal to confirm an intact device and/or complete resection. - If hysterectomy is planned for in patients with the Essure device for indications other than pelvic pain, we recommend en block resection of the fallopian tubes and cornua.

VP13.08: Prenatal findings of cataract and arthrogryposis: cerebro‐oculo‐facio‐skeletal syndrome and review of differential diagnosis

VP13.08: Prenatal findings of cataract and arthrogryposis: cerebro‐oculo‐facio‐skeletal syndrome and review of differential diagnosis

Fat-Containing Lesions of the Liver: A Review of Differential Diagnoses.

The presence of intralesional fat provides an invaluable tool for narrowing the differential diagnosis for both benign and malignant neoplasms of the abdomen and pelvis. The ability to characterize intralesional fat is further expanded by the ability of magnetic resonance imaging to detect small quantities (intravoxel) of fat. The differential diagnosis of fat-containing lesions arising in the liver is broader than that of many other solid organs. However, this differential can be further refined depending on the type of fat (macroscopic vs intravoxel) and with the use of ancillary imaging findings. Radiologists must be aware of benign and malignant mimickers of common lesions.

Meningioma of the Pineal Region — Differential Radiologic Aspects of Pineal Region Tumors Based on a Clinical Case

AbstractPineal region tumors are uncommon among neoplasm of the central nervous system, with this region being the most heterogeneous in terms of histological types. Meningiomas are rarer still, but can be found at this site, with origins in either the velum interpositum or falcotentorial junction. Neuroimaging exams can distinguish malignant from benign lesions besides helping to define the origin of the lesion as the pineal parenchymal or surrounding structures. We report the case of a woman with a pineal region tumor in which differential diagnoses included meningioma and germinoma, with confirmation of the former based on radiological characteristics and histopathology. In addition, a brief review of differential diagnoses and approaches for cases of lesions in this region is provided.

Imaging findings in a case of synovial chondromatosis of temporomandibular joint

Synovial chondromatosis (SC) is a benign pathology that usually affects the joints of axial skeleton and being rare in temporomandibular joint region. Clinically, the presentation can be in the form of swelling, pain, clicking sounds, and mouth opening limitation. Imaging is a vital component to distinguish the conditions similar to SC. A case of SC diagnosed with the help of imaging has been discussed in the present paper along with a brief review of differential diagnosis.

Clinical and imaging features of pedal macrodystrophia lipomatosa in two children with differential diagnosis review

Macrodystrophia lipomatosa (ML) is a rare nonhereditary congenital/developmental disorder. It can manifest in limb overgrowth and disfigurement. In consequence, considerable esthetic and functional implications can develop. To overcome such problems, debulking surgery and digit amputation have been practiced. The diagnosis of ML is largely based on accurate clinical assessment and supplementary imaging modalities. The differential diagnosis of an overgrown limb(s) including ML offers numerous challenges in terms of overlapping clinical features and diversity of prognosis of the involved disorders. This study aims to describe the clinical and radiologic characteristics of two girls with ML of the foot. In particular, we intend to explore the role of magnetic resonance imaging (MRI) in clarifying the pathology and supporting the diagnosis. This study demonstrates that accurate history taking and clinical examination provide a valuable key to the diagnosis of foot ML. We used MRI effectively to delineate the characteristics of ML and confirm the diagnosis. Review of the differential diagnosis suggests a potential and important role for magnetic resonance imaging in the differential diagnosis of overgrowth disorders.

Multimodality imaging findings in rhabdomyolysis and a brief review of differential diagnoses.

Rhabdomyolysis has traditionally been a clinical diagnosis with healthcare providers utilizing historical context, physical exam, and laboratory data to arrive at a diagnosis. However, there are myriad imaging findings that may be corroborative and support the presumptive diagnosis. This paper seeks to review imaging findings associated with rhabdomyolysis using different modalities including radiography, sonography, computed tomography (CT), magnetic resonance imaging (MRI), and bone scintigraphy.

Mucinous Cystic Neoplasm of the Liver with Extrahepatic Growth: A Case Analysis and Review of Differential Diagnoses

Mucinous Cystic Neoplasm of the Liver with Extrahepatic Growth: A Case Analysis and Review of Differential Diagnoses

Review of differential diagnosis and management of spasmodic dysphonia.

The recent literature on spasmodic dysphonia is reviewed with regard to pathogenesis, differential diagnosis, treatment options, audits, and current methods of management. Advances in technology have enabled clinicians to better understand the connection between brain and laryngeal function and dysfunction. Refinements in imaging and genetic investigation techniques have led to advances in the understanding of the underlying mechanism of this neurolaryngeal disorder. Development of diagnostic assessment tools and measures of quality of life hold the potential to improve treatment and care. Fifty articles published between 2014 and 2015 were selected for this review. The sources were drawn from several clinical specialties: 54% come under the scope of laryngology, 32% from neurology, and 14% from other areas. It remains poorly understood, misdiagnosed, and underdiagnosed. Its identification, diagnosis, treatment selection, and coordination of care require an expert specialist multidisciplinary team. More training is required to help people who have this chronic and psychosocially disabling voice disorder, which impinges on all aspects of their lives. Spasmodic dysphonia is now classified as a 'rare' disease in the United States. This designation will assist in international standards of diagnosis, assessment, treatment, and management.

Unilateral Intraparotid Swelling: A Case Report of Kimura’s Disease and Review of Differential Diagnosis

An interesting case of Kimura's disease was described in the 42-year-old patient manifesting itself as a unilateral parotid swelling, albeit the disease usually affects both parotid glands. Furthermore, first pathohistological finding was not suggestive of the disease, revealing only fatty tissue, but on the repeated biopsy together with CT the correct diagnosis was established. It should be emphasized that Kimura's disease has to be taken into account while making differential diagnosis in parotid gland swellings, especially in people of Oriental origin.

Evaluation of transfusion pyrexia: a review of differential diagnosis and management.

Background/purpose. Transfusion pyrexia (fever) is an important clinical sign/symptom occurring either as an isolated event or as part of a constellation of signs and symptoms in relation to blood transfusion. It is an important cause of morbidity and may be an important sign of life-threatening complications of blood transfusion. Pyrexia is often a reason for the discontinuation of a blood transfusion episode, and adequate evaluation remains a challenge for clinicians. The decision to stop a blood transfusion episode on account of fever is often a difficult one. This paper reviews the differential diagnosis of transfusion pyrexia (TP), the pathogenesis as well as current management measures. Study selection and data source. Literature sources include medical texts, journals, dissertations, and internet-based electronic materials Results and conclusion. Adequate evaluation of pyrexia accompanying blood transfusion remains a challenge for clinicians. An algorithm to assist the clinician in the evaluation of fever occurring in a blood transfusion recipient is developed and presented. Continuous medical education is necessary for clinicians towards improved patient care in transfusion medicine.

Thoraco- Omphalo-Ischiopagus Tripus Conjoined Twins: Report of a Case

The frequency of thoraco- omphalo-ischiopagus tripus or conjoined twins (CT) is quite rare of mozygotic twinnings, and they are classified as unions of symmetrical CT. A case of conjoined twins with thoraco- omphaloischiopagus type is presented here as well as a review of differential diagnosis. The twins had two heads, two pairs of upper limbs and three lower limbs. They also shared thorax, abdomen and pelvis with a single beating heart.

Giant Inverted T waves in the emergency department: case report and review of differential diagnoses

Inverted T waves are frequently seen in electrocardiograms (ECGs) and may represent a myriad of pathologies or nonspecific change. However, deep (giant) inverted T waves are only seen in a few clinical conditions. Presence of giant T waves should generally prompt investigations for apical (Yamaguchi) variant of hypertrophic cardiomyopathy, raised intracranial pressure, severe myocardial ischemia, posttachycardia syndrome, and others. This report describes an unusual case of moderate but not massive pulmonary embolism presenting with an ECG finding of giant inverted T waves. A review of the common conditions associated with such an ECG is also presented.

Hematologic malignancies of the female genital tract diagnosed on liquid‐based Pap test: Cytomorphologic features and review of differential diagnoses

The female genital tract is rarely the primary site for hematologic malignancies; however, secondary involvement of this anatomic site is common. Primary lymphomas of the gynecologic tract are reported to represent less than 1% of extranodal non-Hodgkin lymphomas (NHL), and the majority of them being B-cell in origin. Diffuse large B-cell lymphoma is the most common subtype, whereas primary extraosseus plasmacytoma of the genital tract is rare.If clinically not suspected, these rare tumors pose a diagnostic challenge both for clinicians and pathologists. Clinical symptoms are often nonspecific and mimic other more common gynecologic malignancies such as squamous cell carcinoma of the cervix or endometrial adenocarcinoma. Although cervico-vaginal (Pap) smear is the primary screening method for cervical squamous cell carcinoma and its precursors, it is far less sensitive for detection of other primary or metastatic malignancies. In this review, we present three cases of hematologic gynecologic malignancies, two cases of primary NHL, and a case of acute myeloid leukemia with relapse as a pelvic mass, all of which were diagnosed on a liquid-based Pap test. In addition, we discuss the morphologic features of differential diagnostic entities of these rare tumors on conventional and liquid-based preparations.

A case of congenital bilateral absence of elbow flexor muscles: review of differential diagnosis and treatment.

A 1-year-old boy presented to us with congenital inability to flex his elbow. He had bilaterally absent biceps brachii and brachialis muscles, a rare condition. We performed pedicle latissimus dorsi musculocutaneous flaps to the left and right volar upper arm at 21 and 24 months of age, respectively, to create elbow flexors. By 4 years of age, he had excellent elbow flexion bilaterally with strength grade in excess of 4.5. In addition to discussing our patient's treatment options, we discuss other potential causes of weak elbow flexion when faced with this clinical dilemma.