Otalgia differential diagnosis: Difference between revisions
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==Overview== | ==Overview== | ||
Based on the pain originates,differential diagnosis can be divided into primary and secondary categories.The causes of the Primary otalgia include,infectious,mechanical,neoplastic and inflammatory.Secondary otalgia originates other organ system. Most of the secondary causes related to head and neck. | Based on the pain originates,differential diagnosis can be divided into primary and secondary categories.The causes of the Primary [[otalgia]] include,[[infectious]],mechanical,[[Neoplastic disease|neoplastic]] and [[inflammatory]].Secondary otalgia originates other organ system. Most of the secondary causes related to head and neck. | ||
==Differentiating Otalgia from other Diseases== | ==Differentiating Otalgia from other Diseases== | ||
Based on the pain originates,differential diagnosis can be divided into primary and secondary categories.The causes of the Primary otalgia include,infectious,mechanical,neoplastic and inflammatory.Secondary otalgia originates other organ system. Most of the secondary causes related to head and neck. | Based on the pain originates,differential diagnosis can be divided into primary and secondary categories.The causes of the Primary [[otalgia]] include,[[infectious]],mechanical,[[Neoplastic disease|neoplastic]] and [[inflammatory]].Secondary [[otalgia]] originates other organ system. Most of the secondary causes related to head and neck.<ref name="pmid18245001">{{cite journal| author=Siddiq MA, Samra MJ| title=Otalgia. | journal=BMJ | year= 2008 | volume= 336 | issue= 7638 | pages= 276-7 | pmid=18245001 | doi=10.1136/bmj.39364.643275.47 | pmc=2223060 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18245001 }} </ref><ref name="pmid28846338">{{cite journal| author=| title=StatPearls | journal= | year= 2020 | volume= | issue= | pages= | pmid=28846338 | doi= | pmc= | url= }} </ref> | ||
===Differentiating otalgia from other diseases on the basis of primary and secondary causes=== | ===Differentiating otalgia from other diseases on the basis of primary and secondary causes=== | ||
<ref name="pmid28846338">{{cite journal| author=| title=StatPearls | journal= | year= 2020 | volume= | issue= | pages= | pmid=28846338 | doi= | pmc= | url= }} </ref><ref name="pmid18245001">{{cite journal| author=Siddiq MA, Samra MJ| title=Otalgia. | journal=BMJ | year= 2008 | volume= 336 | issue= 7638 | pages= 276-7 | pmid=18245001 | doi=10.1136/bmj.39364.643275.47 | pmc=2223060 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18245001 }} </ref> | |||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |Otitis media | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Otitis media]] | ||
|otalgia, hearing loss,new onset of otorrhea not caused by otitis externa | |[[otalgia]], hearing loss,new onset of [[otorrhea]] not caused by [[otitis externa]] | ||
|Bulging tympanic membrane,Middle ear effusion | |Bulging [[tympanic membrane]],Middle ear effusion | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Otitis externa | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Otitis externa]] | ||
|otalgia, pruritus, discharge, and hearing loss | |[[otalgia]], [[pruritus]], discharge, and [[hearing loss]] | ||
|Tenderness with tragal pressure,edema and erythema of ear canal | |Tenderness with tragal pressure,edema and erythema of ear canal | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Myringitis | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Myringitis bullosa|Myringitis]] | ||
|otalgia+/-, ear discharge | |[[otalgia]]+/-, ear discharge | ||
|Serous liquid-filled blisters on the tympanic membrane | |Serous liquid-filled blisters on the [[tympanic membrane]] | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Eustachian tube dysfunction | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Eustachian tube dysfunction]] | ||
|otalgia, a sensation of ear fullness or pressure, hearing loss, tinnitus,autophony | |[[otalgia]], a sensation of ear fullness or pressure, [[hearing loss]], [[tinnitus]],autophony | ||
|Retracted tympanic membrane , short process is more prominent, manubrium (or handle) of the malleus appears shorter | |Retracted [[tympanic membrane]] , short process is more prominent, [[manubrium]] (or handle) of the [[malleus]] appears shorter | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Cerumen impaction | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Cerumen impaction|Foreign body,cerumen impaction]] | ||
| | |[[otalgia]],[[hearing loss]], sense of fullness,Insects, small objects Commonly occurs in children | ||
| | |Foreign body visible in ear canal[[Cerumen|, cerumen]] | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Barotrauma | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Barotrauma]] | ||
| | |Pain onset during descent of airplane or while scuba diving | ||
| | |[[Tympanic membrane]] hemorrhage Serous or hemorrhagic middle ear fluid | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Cholesteatoma | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Cholesteatoma]] | ||
| | |painless [[otorrhea]], [[Hearing loss]],[[Dizziness|dizzinesss]] | ||
| | |white keratinaceous debris in the posterosuperior [[tympanic membrane]] quadrant | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Wegener granulomatosis | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Wegener's granulomatosis|Wegener granulomatosis]] | ||
| | |[[Arthralgia]] ,[[Hearing loss]], [[Myalgia|Myalgias]] ,Oral or nasal ulcers ,[[Otorrhea]] ,[[Rhinorrhea]] | ||
|Often causes [[Otitis media|chronic otitis media]] or serous otitis | |||
| | | | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Sinusitis | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Sinusitis]] | ||
| | |Nasal congestion, Pain in [[Maxillary|maxillary sinuses]] | ||
| | |Nasal congestion Tender over [[maxillary]] sinuses | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Temporomandibular joint | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Temporomandibular joint]] | ||
| | |Pain or [[crepitus]] with talking or chewing | ||
| | |Tender [[TMJ]] Crepitus or clicking on motion of [[mandible]] May have restricted jaw movement | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Dental pathology | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Dental pathology | ||
| | |May have dental complaints or history of dental disorders | ||
| | |Caries [[Abscess]], [[Gingivitis]] ,Facial swelling ,Teeth tender to percussion | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |lymphadenopathy | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Cervical [[lymphadenopathy]] | ||
| | |May have recent upper respiratory infection or scalp lesion | ||
| | |Tender cervical or periauricular lymph nodes | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |pharyngitis | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[pharyngitis]] | ||
| | |Often accompanied by [[sore throat]] | ||
| | |[[Pharyngeal]] or [[Tonsillar Disease|tonsillar]] erythema Swelling Exudate | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |myocardial infarction | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[myocardial infarction]] | ||
| | |Cardiac risk factors | ||
| | |Usually none | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Gastroesophageal reflux disease (GERD) | | style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Gastroesophageal reflux disease|Gastroesophageal reflux disease (GERD)]] | ||
| | |[[Heartburn]] ,Acid reflux | ||
| | |Usually none | ||
|- | |- | ||
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Idiopathic or psychogenic | | style="background: #DCDCDC; padding: 5px; text-align: center;" |Idiopathic or [[psychogenic]] | ||
| | |Variable,History of [[depression]] or [[anxiety]] | ||
| | |Normal,Blunted affect Depressed mood | ||
|} | |} | ||
Latest revision as of 18:41, 28 January 2021
Overview
Based on the pain originates,differential diagnosis can be divided into primary and secondary categories.The causes of the Primary otalgia include,infectious,mechanical,neoplastic and inflammatory.Secondary otalgia originates other organ system. Most of the secondary causes related to head and neck.
Differentiating Otalgia from other Diseases
Based on the pain originates,differential diagnosis can be divided into primary and secondary categories.The causes of the Primary otalgia include,infectious,mechanical,neoplastic and inflammatory.Secondary otalgia originates other organ system. Most of the secondary causes related to head and neck.[1][2]
Differentiating otalgia from other diseases on the basis of primary and secondary causes
| Diseases | symptoms | physical examination | |
|---|---|---|---|
| Otitis media | otalgia, hearing loss,new onset of otorrhea not caused by otitis externa | Bulging tympanic membrane,Middle ear effusion | |
| Otitis externa | otalgia, pruritus, discharge, and hearing loss | Tenderness with tragal pressure,edema and erythema of ear canal | |
| Myringitis | otalgia+/-, ear discharge | Serous liquid-filled blisters on the tympanic membrane | |
| Eustachian tube dysfunction | otalgia, a sensation of ear fullness or pressure, hearing loss, tinnitus,autophony | Retracted tympanic membrane , short process is more prominent, manubrium (or handle) of the malleus appears shorter | |
| Foreign body,cerumen impaction | otalgia,hearing loss, sense of fullness,Insects, small objects Commonly occurs in children | Foreign body visible in ear canal, cerumen | |
| Barotrauma | Pain onset during descent of airplane or while scuba diving | Tympanic membrane hemorrhage Serous or hemorrhagic middle ear fluid | |
| Cholesteatoma | painless otorrhea, Hearing loss,dizzinesss | white keratinaceous debris in the posterosuperior tympanic membrane quadrant | |
| Wegener granulomatosis | Arthralgia ,Hearing loss, Myalgias ,Oral or nasal ulcers ,Otorrhea ,Rhinorrhea | Often causes chronic otitis media or serous otitis | |
| Sinusitis | Nasal congestion, Pain in maxillary sinuses | Nasal congestion Tender over maxillary sinuses | |
| Temporomandibular joint | Pain or crepitus with talking or chewing | Tender TMJ Crepitus or clicking on motion of mandible May have restricted jaw movement | |
| Dental pathology | May have dental complaints or history of dental disorders | Caries Abscess, Gingivitis ,Facial swelling ,Teeth tender to percussion | |
| Cervical lymphadenopathy | May have recent upper respiratory infection or scalp lesion | Tender cervical or periauricular lymph nodes | |
| pharyngitis | Often accompanied by sore throat | Pharyngeal or tonsillar erythema Swelling Exudate | |
| myocardial infarction | Cardiac risk factors | Usually none | |
| Gastroesophageal reflux disease (GERD) | Heartburn ,Acid reflux | Usually none | |
| Idiopathic or psychogenic | Variable,History of depression or anxiety | Normal,Blunted affect Depressed mood |