Importance of General Physical Examination in Avoiding Oversight of Significant Clinical Findings
Keywords:
Physical Examination, hairy mole, pilonidal sinus
Abstract
General Physical Examination skills are gradually fading away from clinical practice, ever since the advent
of technological advancements. Bedside learning is shifting to classrooms, increasing the reliance on diagnostic
reports and decreasing the quality of personalised medical care. An efficient clinical examination
is essential in all medicos, from medical students to practising doctors to avoid missed or delayed diagnosis
or treatment. Here, we present the case of a patient of pilonidal sinus in whom a large hairy mole was
initially missed due to omission of proper GPE.
References
1. Asif T, Mohiuddin A, Hasan B, Pauly RR. Importance of thorough physical examination: a lost art. Cureus. 2017;9(5) .https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5453739/
2. Verghese A, Charlton B, Kassirer JP, Ramsey M, Ioannidis JP. Inadequacies of physical exami-nation as a cause of medical errors and adverse events: a collection of vignettes. The American Journal of Medicine. 2015, 128:1322-
4. https://www.sciencedirect.com/science/article/abs/pii/ S0002934315005495
3. Haring CM, Cools BM, van der Meer JW, Postma CT. Student performance of the general physi-cal examination in internal medicine: An Observational Study. BMC Medical Education. 2014,14 : 73 https://bmcmededuc.biomedcentral. com/articles/10.1186/1472-6920-14-73
4. Meshram GG, Kaur N, Hura KS. Giant congenital melanocytic nevi: an update and emerging therapies. Case Reports in Dermatology. 2018;10 :24-8. https://www.karger.com/ Article/Abstract/487002
5. New recommendations for the categorization of cutaneous features of congenital melanocytic ne-vi.Krengel S1, Scope A, Dusza SW, Vonthein R, Marghoob AA. J Am Acad Dermatol. 2013 Mar;68(3):441-51. doi: 10.1016/j.
jaad.2012.05.043. Epub 2012. https://www.sciencedirect. com/science/article/abs/pii/S0190962212007876
6. Viana AC, Gontijo B, Bittencourt FV. Giant congenital melanocytic nevus. Anais Brasileiros de Dermatologia. 2013; 88:863-78. http://www.scielo.br/scielo.php?pid=S0365-
05962013000600863&script=sci_arttext
7. Nichols L, Hernandez M, Henderson IV JH. Infective Endocarditis Masked by Narrow Focus Thinking, Inadequate Physical Examination and Analgesic Medication. Cureus. 2019 ;11(9) https://www.ncbi.nlm.nih. gov/pmc/articles/PMC6822879/
8. Durai R, Hoque H, Ng P. The Acute Abdomen - Commonly Missed AndMis-diagnosed Condi-tions: Review. Webmed Central SURGERY 2010;1(10):WMC001036. doi: 10.9754/ journal.wmc.2010.001036 http://www.webmedcentral.com/ article_view/1036
9. Block L, Habicht R, Wu AW, Desai SV, Wang K, Silva KN, Niessen T, Oliver N, Feldman L. In the wake of the 2003 and 2011 duty hours regulations, how do internal medicine interns
spend their time?. Journal of General Internal Medicine. 2013;28 : 1042-7. https://link.springer.com/article/10.1007/ s11606-013-2376-6.
2. Verghese A, Charlton B, Kassirer JP, Ramsey M, Ioannidis JP. Inadequacies of physical exami-nation as a cause of medical errors and adverse events: a collection of vignettes. The American Journal of Medicine. 2015, 128:1322-
4. https://www.sciencedirect.com/science/article/abs/pii/ S0002934315005495
3. Haring CM, Cools BM, van der Meer JW, Postma CT. Student performance of the general physi-cal examination in internal medicine: An Observational Study. BMC Medical Education. 2014,14 : 73 https://bmcmededuc.biomedcentral. com/articles/10.1186/1472-6920-14-73
4. Meshram GG, Kaur N, Hura KS. Giant congenital melanocytic nevi: an update and emerging therapies. Case Reports in Dermatology. 2018;10 :24-8. https://www.karger.com/ Article/Abstract/487002
5. New recommendations for the categorization of cutaneous features of congenital melanocytic ne-vi.Krengel S1, Scope A, Dusza SW, Vonthein R, Marghoob AA. J Am Acad Dermatol. 2013 Mar;68(3):441-51. doi: 10.1016/j.
jaad.2012.05.043. Epub 2012. https://www.sciencedirect. com/science/article/abs/pii/S0190962212007876
6. Viana AC, Gontijo B, Bittencourt FV. Giant congenital melanocytic nevus. Anais Brasileiros de Dermatologia. 2013; 88:863-78. http://www.scielo.br/scielo.php?pid=S0365-
05962013000600863&script=sci_arttext
7. Nichols L, Hernandez M, Henderson IV JH. Infective Endocarditis Masked by Narrow Focus Thinking, Inadequate Physical Examination and Analgesic Medication. Cureus. 2019 ;11(9) https://www.ncbi.nlm.nih. gov/pmc/articles/PMC6822879/
8. Durai R, Hoque H, Ng P. The Acute Abdomen - Commonly Missed AndMis-diagnosed Condi-tions: Review. Webmed Central SURGERY 2010;1(10):WMC001036. doi: 10.9754/ journal.wmc.2010.001036 http://www.webmedcentral.com/ article_view/1036
9. Block L, Habicht R, Wu AW, Desai SV, Wang K, Silva KN, Niessen T, Oliver N, Feldman L. In the wake of the 2003 and 2011 duty hours regulations, how do internal medicine interns
spend their time?. Journal of General Internal Medicine. 2013;28 : 1042-7. https://link.springer.com/article/10.1007/ s11606-013-2376-6.
Published
2020-02-25
How to Cite
Goyal, S. (2020). Importance of General Physical Examination in Avoiding Oversight of Significant Clinical Findings. The Indian Practitioner, 73(2), 32-34. Retrieved from https://articles.theindianpractitioner.com/index.php/tip/article/view/928
Section
Case Reports