Sandbox: differentialdx maria

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Differential Diagnosis Similar Features Differentiating Features
Osteoblastoma
  • Benign, male predilection, and also present in long bones
  • In osteoblastoma, differentiating features include: uncommon tumor, affect the axial skeleton more frequently and lesions are typically larger than 2 cm
Brodie abscess
  • Present in children, limb pain, and ocassionaly affects long bones
  • In brodie abscess differentiating features include: fever, subacute onset, and location is usually affects the metaphysis of tubular bones
Osteosarcoma
  • Affects same group of population (children and adolescents), patients usually present with bone pain, and the location is usually long bones
  • In osteosarcoma, differentiating features include: malignancy, infiltration to surrounding tissue, and elevation of serum alkaline phosphatase (ALP)
Enostosis
  • Affects same group of population (children and adolescents), small size, and the location is usually long bones
  • In enostosis, differentiating features,include: pathognomonic radiological appearance, incidental finding
Differential Diagnosis Similar Features Differentiating Features
Fibrous dysplasia
  • Benign, often an incidental finding, and affects the same group of patients.
  • In fibrous dysplasia, differentiating features include: More common presentation is on ribs: 28%, no gender predilection, and complete resection is usually not possible.
Osteoblastoma
  • Benign, incidental, and male predilection.
  • In osteoblastoma, differentiating features include: normally affect the axial skeleton, lesions are typically larger than 2 cm, and surgical excision is often the treatment of choice.
Adamantinomas
  • Benign, slow growing, similar clinical onset.
  • In adamantinomas , differentiating features include: locally aggressive tumor, common in the 3rd to 5th decades of life, location is usually confined to the jaw.
Chronic sinusitis
  • Affects same group of population (young to middle aged adults), clinical onset is similar.
  • In chronic sinusitis, differentiating features include: fever, previous history of acute sinusitis, and lack of facial deformation or imaging findings compatible with osteoma.




Differential Diagnosis Similar Features Differentiating Features
Cardiac tamponade
  • Elevated jugular venous pressure, reduced diastolic filling of the right ventricle, and hypotension.
  • In cardiac tamponade, differentiating features include: muffled heart sounds, pericardial rub, and electrocardiographic changes.
Chronic obstructive pulmonary disease
  • Elevated jugular venous pulse (JVP), shortness of breath, and tachypnea.
  • In cardiac tamponade, differentiating features include: history of chronic bronchitis, coarse crackles with inspiration, and spirometry with FEV1/FVC < 70%.
Mediastinitis
  • Elevated venous pressure, tachypnea and shortness of breath.
  • In mediastinitis, differentiating features include: fever, positive confirmation of organisms and elevated leukocytes.
Pneumonia
  • Hypotension, tachypnea,cough, and chest pain.
  • In pneumonia, differentiating features include: Bronchial breath sounds, leukocytosis with left shift, positive blood culture and altered laboratory findings (procalitonin).
Acute respiratory distress syndrome
  • Low blood pressure,hypotension, and shortness of breath.
  • In cardiac acute respiratory distress syndrome, differentiating features include: acute onset, bilateral infiltrates on chest radiograph sparing costophrenic angles and pulmonary wedge pressure < 18 mmHg.
Syphilis
  • Enlarged lymph nodes, hypotension and dysphagia.
  • In syphilis, differentiating features include: Positive treponemal tests, history of unprotected sex, and superficial mucosal patches.


Differential Diagnosis Similar Features Differentiating Features
Familial adenomatous polyposis (FAP)
  • Familial inheritance, increased risk of colorectal cancer, extra-colonic tumors.
  • Autosomal recessive, 100+ polyps and age under 40, centinel tumors are differently located than HNPCC, such as: Osteomas, dental anomalies, congenital hypertrophy of the retinal pigment epithelium (CHRPE)
Juvenile polyposis
  • Familial inheritance, autosomal dominant, high risk of GI and non GI cancer, also a germline mutation.
  • Gastrointestinal hamartomatous polyps, on physical exam lip pigmentation is common.
Cowden syndrome
  • Rare autosomal dominant inherited disorder, increased risk of colorectal cancer, also has gene mutations.
  • Intestinal hamartomatous polyps, physical exam may show macrocephaly, gene affected PTEN.