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Diagnosis of exclusion

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Title: Diagnosis of exclusion  
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Subject: Psychosis, Medical diagnosis, Non-celiac gluten sensitivity, Prurigo gestationis, Secondary sclerosing cholangitis
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Diagnosis of exclusion

A diagnosis of exclusion (per exclusionem) is a diagnosis of a medical condition reached by a process of elimination, which may be necessary if presence cannot be established with complete confidence from examination or testing. Such elimination of other reasonable possibilities is a major component in performing a differential diagnosis.

The largest category of diagnosis by exclusion is seen among psychiatric disorders where the presence of physical or organic disease must be excluded as a pre-requisite for making a functional diagnosis. Diagnosis by exclusion tends to occur where scientific knowledge is scarce, specifically where the means to verify a diagnosis by an objective method is absent. As a specific diagnosis cannot be confirmed, a fall back position is to exclude that group of known causes that may cause a similar clinical presentation.


An example of such a diagnosis is "fever of unknown origin": to explain the cause of elevated temperature the most common causes of unexplained fever (infection, neoplasm, or collagen vascular disease) must be ruled out.

Other examples include:

See also


  1. ^ "Behcet Disease: Overview - eMedicine Dermatology". Retrieved 2009-03-28. 
  2. ^ Petruzzelli GJ, Hirsch BE (August 1991). "Bell's palsy. A diagnosis of exclusion". Postgrad Med 90 (2): 115–8, 121–2, 125–7.  
  3. ^ Freudenreich, O (December 2012). """Differential Diagnosis of Psychotic Symptoms: Medical "Mimics. Psychiatric Times. 
  4. ^ Kwan ES, Wolpert SM, Hedges TR, Laucella M (February 1988). "Tolosa-Hunt syndrome revisited: not necessarily a diagnosis of exclusion". AJR Am J Roentgenol 150 (2): 413–8.  
  5. ^ Cash BD, Chey WD (June 2004). "Irritable bowel syndrome - an evidence-based approach to diagnosis". Aliment. Pharmacol. Ther. 19 (12): 1235–45.  
  6. ^ Cash BD, Chey WD (December 2003). "Advances in the management of irritable bowel syndrome". Curr Gastroenterol Rep 5 (6): 468–75.  
  7. ^ Maltsman-Tseikhin, A; Moricca, P; Niv, D (June 2007). "Burning mouth syndrome: will better understanding yield better management?". Pain practice : the official journal of World Institute of Pain 7 (2): 151–62.  

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