Rafailidis Petros I, Falagas Matthew E
Alfa Institute of Biomedical Sciences, Athens, Greece.
Eur J Intern Med. 2008 Jun;19(4):271-5. doi: 10.1016/j.ejim.2007.06.022. Epub 2008 Feb 20.
History and physical examination are the basis of any diagnosis. The findings of the physical examination usually corroborate the thoughts generated by the medical history. However, it is not uncommon for the physician to note discrepancies between the history and the physical examination.
Two physicians provided a list of diseases they have encountered in which there is occasionally discordance between the data retrieved from the patient's medical history and the findings of the physical examination. To verify the data from knowledge and experience, we resorted to two main medical textbooks and relevant articles from PubMed.
We identified 25 diseases where a discordance between history and physical examination may frequently be observed. These diseases cover a wide spectrum of systems (i.e., neurological, cardiological, respiratory, and gastrointestinal).
A variety of diseases are associated with a discordance between the findings one might expect based on the medical history and the actual findings of the physical examination. Physicians need to be aware of this paradox, as misdiagnosis can be detrimental in some of these diseases. We acknowledge that this is just a sample, and not an exhaustive list, of all diseases with such a discordance.
病史和体格检查是任何诊断的基础。体格检查的结果通常会证实病史所引发的判断。然而，医生注意到病史与体格检查之间存在差异的情况并不少见。
两位医生列出了他们遇到过的一些疾病，这些疾病中患者病史所获取的数据与体格检查的结果偶尔会出现不一致。为了根据知识和经验核实这些数据，我们查阅了两本主要的医学教科书以及来自PubMed的相关文章。
我们确定了25种疾病，在这些疾病中经常可以观察到病史与体格检查之间的不一致。这些疾病涵盖了广泛的系统（即神经系统、心血管系统、呼吸系统和胃肠道系统）。
多种疾病都存在基于病史可能预期的结果与体格检查实际结果之间的不一致。医生需要意识到这种矛盾情况，因为在其中一些疾病中误诊可能是有害的。我们承认这只是所有存在这种不一致情况疾病的一个样本，而非详尽无遗的列表。
