How to present a medical mystery online in a way that allows solving it? That is the question

 In my previous blog, I spoke about the difference between presenting a patient with a difficult-to-diagnose disorder which already has been diagnosed and one that has yet to be diagnosed. The discussion of this problem sounds like a useless exercise, until comes the moment where you have to present your undiagnosed patient to colleagues.

In everyday life, we as doctors have become accustomed to dealing with the lacking information in a case presentation by talking to the patients and examining them ourselves. But when it comes to presenting the case in an online discussion in front of a physician network, we have to choose a different way.

This point makes the quality of presentation a necessary condition for successfully brainstorming the right diagnostic assumption.

So how do you present a medical case in a qualitative manner?

Here are some tips: 

• Defining the main problem- It's very important to define exactly what is the main health problem that the patient suffers from. If this problem is a symptom, it can be defined as the chief complaint bringing the sick person to seek help from doctors. Sometimes, especially in children’s diseases, the finding that draws the attention of the parents and the doctor may be described in terms of a physical examination. Generally, in current medical practice, a finding defined as the main problem can arise from an imaging examination or laboratory tests.

• Be precise- It is very important to present the main problem meticulously, including the full details of its development. Whether it is a laboratory finding or a reference test result, it is extremely important to specify the test method. If you haven't found the main problem you defined in the website's search engine, do not despair. The engine is updated according to new cases that arise on the site. Defining the problem correctly allows the case moderator to explain to you what are the crucial details required for solving the case. Completing these details allows experienced physicians to immediately identify diagnoses they are familiar with, or they realize that the case is truly unusual.

• The exceptional is the most important- its very important to mention in the case presentation all the findings that seemed as unusual. Especially when it comes to symptoms that can be documented, such as a rash, a walking disorder, unusual physique etc.

• Put your heart in it- Don’t forget that we are not discussing a medical case, we are talking about a patient! Tell us more about the person who is behind the medical mystery. Tell us about suffering he is going through. Participating in the discussion is a time consuming job. In order to involve other doctors’ feelings and encourage them to dedicate their time and experience, you must touch their hearts.

In the end, it is important to remember that presenting a patient with an unclear diagnosis is a question. So the accuracy of the answer, depends on how fully and adequately we ask our colleagues - how we formulate our problem.