BEWARE OF SELF DIAGNOSIS

Once a patient consulted me, and he said that “Please treat my swollen kidney”. What surprised me was, it was his first consultation, and he had not even done an ultra sound scanning to detect his swollen kidney. Still, I had to write the things in his own words, ‘swollen kidney’. I then asked him how he came to know that his kidney is swollen? Then he said, “Very simple, I could see easily”, and he lifted his dress and exposed the swollen scrotum! So, he wrongly used the word ‘kidney’ to say that his scrotum is swollen. So the best option is, we can use the own words of the patient, but use it with double inverted commas (“kidney”). Similarly, there are many conditions in which patients will present with some common presenting term or self diagnosis that needs to be investigated properly for better clarity. Never jump into a wrong diagnosis!
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Here are some examples:
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A. A patient comes and say, “I have nasal polyp”, then it could be:

• Adenoids (in children)
• Turbinate hypertrophy
• Severe DNS
• Nasal polyp
• Pyogenic granuloma, etc.
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  B. A patient comes and say, “I have gas or pith”, then it could be:
• Myocardial infarction
• Globus hystericus, Esophageal spasm
• APD
• GERD
• Hiatus hernia
• Esophagitis
• Indigestion, food poisoning, etc.
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  C. A patient comes and say, “I have migraine”, then it could be:
• Migraine
• Cluster headache
• Tension headache
• Temporal arteritis
• Vascular headache
• SOL in brain
• Sinusitis
• Trigeminal neuralgia
• Glaucoma, etc
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  D. A patient comes and say, “I have bone erosion”, then it could be:
• Osteo arthritis
• Rheumatoid arthritis
• Enthesitis
• Ligament tear
• Myofascitis
• Frozen shoulder
• Bursitis
• Pyogenic arthritis
• Osteosarcoma
• TB of joint
• Reactive arthritis
• Secondary CA, etc.
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  E. A patient comes and say, “I have thyroid”, then it could be:
• Hypothyroidism
• Hyperthyroidism
• Hashimotos thyroiditis
• Thyroid cyst
• Goitre
• CA thyroid
• Lipoma in front of neck (l had one case)
• Thyroglossal cyst, etc.
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  F. A patient comes and say, “I have skin allergy”, then it could be:
• Atopic dermatitis
• Contact dermatitis
• Neurodermatitis – Itch scratch syndrome
• Tinea cruris, T coporis, T capitis, etc
• Pyoderma
• Dependent eczema
• Eczema
• Lamellar ichthyosis
• Lichen plannus
• Psoriasis
• Impetigo
• Epidermolysis bullosa
• Pemphigus, etc.
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  G. A patient comes and say, “I have piles”, then it could be:
• Rectal cancer
• Piles
• Anal fissure
• Fistula
• Warts, skin tag, polyp at the anal orifice
• Rectal prolapse.
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  H.” A patient comes and say, “I have mucous problem”, then it could be:
• Sinusitis
• Eustachian catarrh
• Pharyngitis
• Laryngitis
• Bronchitis
• Hyperactive airway syndrome
• COPD
• Pneumonia
• Bronchogenic carcinoma
• Lung metastasis
• Lung fibrosis
• Pleural effusion
• Pneumothorax
  The list will never ends here, there are many more to be included. You can include more as per the cases you get.

Dr Muhammed Rafeeque
Kerala, India.