The value of the history and physical answer

Great answers from the readers.  We made a presumptive diagnosis of diabetic thoracic radiculopathy.  We ordered a nerve conduction test, but the neurologist agreed with the diagnosis and said the test was unnecessary (kudos to the neurologist).  We started the patient on gabapentin and within 24 hours the pain was greatly decreased. This was only the 2nd time in my career that I personally diagnosed this syndrome.  The students, interns and residents were excited and will likely never forget this potential diagnosis. The biggest clue here was the severity of pain without other symptoms and an extensive evaluation previously.  I wonder if I would have made the diagnosis and avoided the CT scan.  I hope so, but I cannot say with certainty.
Source: DB's Medical Rants - Category: Health Medicine and Bioethics Commentators Authors: Tags: Medical Rants Source Type: blogs