Simple Bedside Test Trumps Mega-Workup

The Journal of Family Practice just published an illustrative case of a young woman with severe headaches and blurry vision. After a couple of hospitalizations with non-contrast and contrast brain MRIs, lumbar puncture and exhaustive laboratory testing, the diagnosis was made with a no-cost two minute bedside test, promoted by yours truly in a post titled “Low Tech Medicine” over at “A Country Doctor Writes”: The Pinhole test – looking through a small pinhole corrects most errors of refraction. The young woman’s vision normalized when she looked through a pinhole. She just needed stronger glasses.

http://www.jfponline.com/home/article/frontal-headaches-periocular-discomfort-blurred-vision-dx/9f0913604f6b79ae27ffaa67a2387bbd.html

One Comment to “Simple Bedside Test Trumps Mega-Workup”

  1. I can totally relate to using technology and still having to go backwards to get a result. I had a car accident a few years ago which caused my air bag to deploy. My thumbs were slammed backward and I thought that I had actually broken my R wrist due to increased pain and bruising. Xrays showed that all was well in the fracture department. After a year of pain and physical therapy, I went back to my hand specialist and explained that I continued to have a tremendous amount of pain just under my thumb and I explained that if I could just pull my thumb off and get in there I could show him where it hurt. After MRI and a joint dye injection test which was really painful, the results came back normal. On my return visit I explained that I saw the dye exit the joint space during the test and I was concerned about the accuracy. He asked me once again to show him exactly where my pain was. Oh he says, hold on. Off we go to the xray room where he proceeds to snap a very simple xray and bam there’s the answer. My thumb was not sitting in the correct placement and a surgery would fix the torn tendon problem. UGH!!!!!

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