A great way to come up with a thorough differential diagnosis is to use a grid. This is very helpful for less experienced professionals or students.

Less experienced people need a systematic framework for constructing a differential diagnosis. A good framework can be developed using a two-dimensional grid, one axis being anatomic (referring to organs or structures), and the other listing disease mechanisms within each anatomic region (e.g. vessel-related, infectious, neoplastic, etc.). The VINDICATED MEN mnemonic is an easy way to remember all major mechanisms of disease.

“Possible diagnoses that can explain major symptoms can then be fitted into the resulting grid. Examples are shown in this report for abdominal pain, chest pain, and edema. Such formulations may seem overly complete, but completeness is actually advantageous for students who are just starting to learn clinical medicine. Then, as they learn more about disease patterns and likelihood of occurrence, and elicit additional information from their patients, they can narrow and refine the diagnostic possibilities.” Am J Med. 1985

Reference

Am J Med. 1985 Dec;79(6):745-9.

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