The approach to a diagnostic dilemma

Diagnostic dilemmas refer to situations in which physicians face a challenging clinical scenario. The goal of our paper is to outline strategies which we have found to be most helpful in the approach to a diagnostic dilemma. We review each strategy and provide illustrative clinical examples. Among the most helpful strategies are performing a thorough history and physical examination (H&P) (including pertinent epidemiological factors and careful medication review), avoidance of non-specific testing and empiric treatment, judicious use of consultants, maintaining an open-mind and humility and ongoing, open communication with your patient.