Discordance between data acquired by history and findings of physical examination: a phenomenal paradox.

BACKGROUND

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.

METHODS

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.

RESULTS

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).

DISCUSSION

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.