Idiopathic hypertrophy of the masseter muscle is a rare disorder of unknown cause. Some authors associate it with the habit of chewing gum, temporo-mandibular joint disorder, congenital and functional hypertrophies, and emotional disorders (stress and nervousness). Most patients complain of the cosmetic change caused by facial asymmetry, also called square face, however, symptoms such as trismu...

introduction: elevated intracranial pressure (icp) is a major and potentially lethal disorder in patients admitted to the emergency department (ed). several methods are being used to investigate for elevated icp. here we assessed and compared the diagnostic accuracy of two existing tools of ophthalmoscopy and optic nerve ultrasonography in detection of elevated icp. methods: 131 participants wi...

BACKGROUND Poor authenticity in high stake clinical exams adversely effects validity. We propose including known misleading diagnostic factors and contextual biases in the assessment of diagnostic skills amongst advanced specialty trainees. We hypothesise that this strategy offers a more realistic and critical assessment of diagnostic skill than strategies in which candidates are presented with...

BACKGROUND Carpal tunnel syndrome (CTS) is a major occupational illness in the US. The Wisconsin Test is a quantitative computer-controlled test battery designed for measuring sensory and psychomotor function. Subjects were recruited from industrial jobs at high-risk for CTS to determine if subtle sensory and motor deficits were observable in a working population. Outcomes were studied for pote...

BACKGROUND In clinical practice a diagnosis is based on a combination of clinical history, physical examination and additional diagnostic tests. At present, studies on diagnostic research often report the accuracy of tests without taking into account the information already known from history and examination. Due to this lack of information, together with variations in design and quality of stu...

A 46-year-old female was admitted to the hospital with jaundice and pruritus. The patient had no previous history of liver or biliary disease. She had no reported any drug use nor had she any history of cigarette smoking or drinking alcohol. In the physical exam, she had icterus in the sclera of her eyes, and no pathologic exam finding was observed other than mild painless hepatomegaly. There w...

We reviewed the charts of 100 patients admitted to the hospital for evaluation of syncope. The charts were examined with special attention given to the causes of syncope, the frequency and benefit of diagnostic tests, and the relative cost of these tests. In 39 patients no etiology for syncope was found, and another 18 were felt to have had a vasovagal episode. Twelve patients had arrhythmias a...