March 1, 2016

The young female with lower abdominal pain. The middle-aged male with atypical chest pain. The elderly female that presents with vague symptoms of dizziness. These are just the tip of the iceberg of chief complaints we will see in our emergency medicine careers. Those with symptoms that don’t fit into a particular diagnostic box or with totally clean workups can be frustrating for patients and physicians alike. We are taught in medical school that 90% of diagnoses can be made with a very meticulous history and physical. But, until I was asked to write on the topic of diagnostic uncertainty, I had never really thought about how infrequently we actually make a slam dunk, no doubt about it diagnosis.