The Diagnostic Power of Description

Abstract

Medical students can make an important difference for their patients by giving clear, accurate, and appropriately detailed descriptions of the key history and physical exam findings on rounds. Careful description can expedite diagnosis and improve patient care. Classic nineteenth-century case reports of axillary arteriovenous aneurysm (Osler) and adhesive pericarditis (Broadbent) show the diagnostic power of description in the pre-diagnostic imaging era. Our current overreliance on imaging has led to a decline in physical exam skills and probably a parallel decline in the description of physical findings. The importance of careful description in the diagnosis of aortic stenosis, neurogenic claudication, Lyme disease, and several other conditions is demonstrated in a series of brief case vignettes. Use of standard medical terminology can be helpful, but there is always room for creativity in clinical description.