Diagnosis of exclusion
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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.
Other examples include:
- Chronic fatigue syndrome[1]
- Fibromyalgia[2]
- Adult-onset Still's disease[3]
- Behçet's disease[4]
- Bell's palsy[5]
- Burning mouth syndrome[6]
- Chronic recurrent multifocal osteomyelitis[7]
- Long COVID[8]
- Psychogenic polydipsia[9]
- Schizophrenia[10]
- Somatic symptom disorder[11]
- Sudden infant death syndrome[12]
- Tolosa–Hunt syndrome[13]
See also
- Idiopathic
References
- PMID 21244747.
- PMID 34786265.
- S2CID 19431424.
- ^ "Behcet Disease: Overview – eMedicine Dermatology". Retrieved 2009-03-28.
- PMID 1862038.
- S2CID 4820793.
- PMID 24302781.
- 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.
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: CS1 maint: multiple names: authors list (link) - ^ Freudenreich, O (December 2012). "Differential Diagnosis of Psychotic Symptoms: Medical 'Mimics'". Psychiatric Times. Archived from the original on 2013-06-04. Retrieved 2013-12-25.
- PMID 29946208.
- PMID 32809642. Retrieved 2024-03-13.
- S2CID 32214113.