Each year, up to 40% of Americans who are seen in an emergency room or intensive care unit are misdiagnosed. In some cases, a patient's condition is correctly diagnosed, and appropriate treatment is administered later. In other cases, the time that is lost through a misdiagnosis can be life-threatening.
Example: A patient who has painful abdominal cramping may be diagnosed with "gastroenteritis" (inflammation of the gastrointestinal tract) when the real culprit is a potentially fatal bowel obstruction.
Important: Listen to your intuition, but don't try to self-diagnose your problem. Get a complete evaluation from your doctor and a second opinion, if desired.
Here are some conditions that are frequently misdiagnosed...
Wrong diagnosis: Gastroenteritis. Gastroenteritis can be caused by ingesting food or water contaminated with a virus (Norwalk virus, adenovirus)...a bacterium (Salmonella, Escherichia coli)...a parasite Giardia)...rare microorganisms (amoebas or parasitic worms)...or a food allergy. Gastroenteritis can result in cramping, vomiting and/or diarrhea.
But these symptoms also can characterize bowel obstruction (commonly caused by scar tissue from previous abdominal or pelvic surgery)... appendicitis...gallbladder disease...or antibiotic-associated colitis.
Self-defense: Do not accept a diagnosis of "gastroenteritis” if your symptoms include...
- Crampy abdominal pain that comes and goes. This could indicate a bowel obstruction
- Pain that begins around the navel and migrates to the lower right abdomen. This could be appendicitis.
- Sudden pain in the upper-right abdomen after eating a high-fat meal. This symptom could be due to a gallbladder attack.
- Severe diarrhea, abdominal pain and/or fever. These symptoms could be caused by pseudomembranous colitis, an inflammatory condition of the colon that occurs in some people who have used antibiotics. It's usually caused by overgrowth of the bacterium Clostridium difficile.
To diagnose your condition correctly, your doctor should take a thorough medical history and perform a physical exam. Tests may include blood work, X-rays and an ultrasound or computed tomography (CT) scan.
Wrong diagnosis: Migraine. More than 45 million people seek medical care each year for headaches. Many have a true migraine, a severe headache often accompanied by nausea, vomiting and/or extreme sensitivity to light and sound. Others have a tension or cluster headache.
In rare cases, a headache can signal a potentially serious condition, such as a stroke...a ruptured brain aneurysm (a weakened blood vessel that has burst)...a contusion (bruising of the brain)...a concussion (a head injury that can cause headache, confusion and amnesia)...a subdural hematoma (bleeding from veins between the outer and middle layers of tissue covering the brain, usually following a head injury)...a brain tumor...meningitis (a bacterial or viral infection of the membrane that surrounds the spinal cord and brain)...or a sinus infection.
Self-defense: Do not accept a diagnosis of "migraine" if your symptoms include...
- Headache with confusion, weakness on one side of the body, double vision and/or trouble speaking. This could indicate a stroke.
- "The worst headache of my life" or a headache that "hits like a lightning bolt." These are signs of a possible stroke or ruptured brain aneurysm.
- Headache that gets worse after coughing, exertion, straining or sudden movement. This can indicate a ruptured brain aneurysm.
- Headache after a head injury, especially if the headache gets worse over the next day or two. It could be a brain injury, such as a contusion, concussion or subdural hematoma.
- New headache pain or changes in headache pattern (location, intensity or frequency), especially in people age 55 or older. This could signal a brain tumor.
- Headache with a fever, stiff neck and/or rash. These are red flags for meningitis.
- Headache after a recent sore throat, cold or flu. This could indicate a sinus infection.
Ask your doctor whether you should be seen by a neurologist. Tests may include blood work, a CT or magnetic resonance imaging (MRI) scan, sinus X-rays or a spinal tap, in which a sample of the fluid that surrounds the brain and spinal cord is withdrawn with a needle and sent to a lal for analysis.
Wrong diagnosis: Muscle strain. Muscle strain often is diagnosed when a person overexerts himself/herself and then experiences pain and/or swelling.
Among the more serious conditions characterized by these symptoms are an infection...or an aortic dissection (a potentially fatal condition in which the inner layer of the wall of the aorta, the main artery of the body, tears).
Self-defense: Do not accept a diagnosis of "muscle strain if your symptoms include…
- Fever and/or a joint that is red and hot. These are red flags for infectious arthritis (infection of the tissues of a joint).
- A "ripping" or "tearing" sensation in the upper back. This commonly occurs in patients who have suffered an aortic dissection.
An evaluation may include X-rays, a CT or MRI scan, blood tests and/or arthrocentesis (removal of joint fluid that is analyzed for bacteria, other microorganisms or gouty crystals).
Wrong diagnosis: Pleurisy. Pleurisy is an inflammation of the pleura, the lining of the lung and inner chest wall. This condition is often diagnosed when a sharp chest pain occurs during inhalation
But chest pain also accompanies heart attack and pulmonary embolism (a blood clot that travels from a leg to the lungs). In addition, pleurisy usually has an underlying cause-such as influenza, pneumonia or fractured ribs which doctors sometimes fail to identify.
Self-defense: Do not accept a diagnosis of "pleurisy" if your symptoms also include...
- Shortness of breath, numbness in your arm and/or sweating. These are all symptoms of a heart attack. In women, heart attack symptoms may include jaw pain, indigestion, back pain and/or fatigue.
- Rapid heart rate, shortness of breath and/ or sharp chest pain that worsens with deep breathing. These could be red flags for a potentially fatal pulmonary embolism,
Your doctor may order a chest X-ray, electrocardiogram (EKG) or lung scan to look for blood clots.
Wrong diagnosis: Rash. Rashes are often harmless immune responses to a substance that a person touches or eats. They usually go away on their own or when treated with over-the-counter cortisone cream.
But rashes also can be due to a bacterial or viral infection.
Self-defense: Do not accept a diagnosis of "rash" if your symptoms also include...
- Fever, chills, severe headache, aches and pains. This can indicate an infection, such as Rocky Mountain spotted fever or scarlet fever.
- Fatigue, muscle and joint stiffness, and a bull's-eye-shaped rash. These are some signs of Lyme disease.
- Chills, fever, nausea and/or fluid-filled blisters in a band on one side of the body. These are signs of shingles.
Your doctor will perform a physical exam and order a blood test and/or other tests, if necessary.
