Differentialdiagnose

A differential diagnosis is the systematic process in medicine of distinguishing a particular disease or condition from others that present with similar signs and symptoms. The goal is to identify the most likely cause and to rule out alternatives, guiding appropriate testing, treatment, and follow-up while minimizing misdiagnosis.

The process typically starts with a thorough history and physical examination to generate a broad list of potential diagnoses. Clinicians then prioritize possibilities by likelihood and by potential severity, ordering targeted tests to confirm or exclude them. Diagnostic reasoning may employ Bayesian updating, clinical criteria, and guideline-based pathways. The differential is refined as new information becomes available, and treatment may be started provisionally with plans to reassess if data contradict the working diagnosis.

Common examples illustrate the approach. Chest pain can have myocardial infarction, unstable angina, pulmonary embolism, pneumonia, reflux, or musculoskeletal causes on the list. Fever with cough might reflect viral or bacterial infection, inflammatory disease, or malignancy, among others. The exact differential depends on patient age, history, risk factors, and presenting features.

Limitations include clinical uncertainty, incomplete information, and cognitive biases that can cause premature closure. A differential diagnosis is a dynamic framework that evolves with data and context, and it is used across medical specialties as well as in related fields such as psychiatry and dentistry, with adaptations to relevant signs and tests. The term differentialdiagnose is sometimes used in non-English contexts to refer to the same concept as differential diagnosis.