What's your Medical Diagnosis: Neck Pain, Hoarseness, Dysphagia

The Isabel diagnosis tool touts an extensive database of conditions for differential diagnosis support, and we often will test its accuracy with real patient cases from the New England Journal of Medicine.

About the Isabel Diagnosis Challenge

The New England Journal of Medicine (NEJM) publishes interesting presentations of common diseases and unusual cases in the Clinical pathology Conference (CPC) series. These cases are educational and can pose diagnostic challenges even to the expert physicians at the Massachusetts General Hospital.

Using the clinical features of these cases you can evaluate your own diagnostic skills and compare your diagnostic performance to that of the physicians at MGH. If you are registered with Isabel as a client or have a free-trial subscription, you can use the diagnosis reminder system and run through some scenarios to get a list of likely suspects. Clicking on a diagnosis will take you through to various knowledge sources and links available from within Isabel.

Today's Case

NEJM 12:18

Demographic: Male, 35y, Neckpain, Hoarseness, Dysphagia, North America
Clinical features:

• right sided neck pain
• dysphagia
• hoarseness
• teeth pain radiating to ear
• blurred vision
• unsteadiness
• difficulty moving tongue to the right
• right horner’s syndrome

STOP! Before you read further, create your own differential diagnosis.

Differential Diagnoses considered by the MGH panel: Transient ischemic attack

Final Diagnosis of the case according to NEJM and Isabel: Villaret’s syndrome (ipsilateral paralysis of the 9th thrpugh 12th cranial nerves and cervical sympathetic fibers) due to a carotid-artery dissection and an associated aneurysm.

Was the final diagnosis given by the Isabel system: Yes, Carotid artery dissection under arterial aneurysms in Vascular