Fitzgerald F T, Tierney L M
West J Med. 1982 Aug;137(2):169-75.
There are a multitude of diagnostic clues contained in clothing, jewelry, possessions and other extracorporeal attachments that each patient brings with him or her to a physician. Because of the emphasis of classic physical diagnosis on the body of a patient solely, and because of modern practices that may have patients stripped of these articles before the first encounter with their physician, these interesting and enlightening findings are often ignored or unavailable. Incorporation of these observations into the panoply of data obtained from the history and physical examination will enhance both the accuracy and adventure of differential diagnosis. Such exercises in observation, moreover, may increase general physical diagnostic skills as well as enliven bedside rounds.
每位患者就医时所携带的衣物、首饰、个人物品及其他体外附着物中蕴含着大量诊断线索。由于传统体格检查仅着重于患者的身体,且现代诊疗流程可能会让患者在首次就医前就脱掉这些物品,这些有趣且具有启发性的发现常常被忽视或无法获取。将这些观察结果纳入从病史和体格检查中获取的全部数据,将提高鉴别诊断的准确性和趣味性。此外,这种观察练习可能会提高一般体格诊断技能,还能活跃床边查房氛围。