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Art and science of a medical diagnosis

A 60-year-old gentleman with diabetes develops a sore on his foot (which he is unaware of because of the nerve changes). It becomes severely infected so he eventually seeks the care of a specialist. This physician takes x-rays and sees some suspicious bone changes, so, to make a definitive diagnosis, he does a biopsy, whereby a piece of bone is obtained from the area of concern. This is sent to a lab where they are able to identify the specific type of bacteria causing the infection.A woman working in an office notices a lump on the side of her foot. Although it is not particularly tender, she is concerned since it is obviously abnormal. Her podiatrist uses a needle to withdraw some of the contents of this lump. The specimen is sent to a lab where a pathologist examines the material removed and determines it is consistent with a common ganglionic cyst, a benign growth off a joint. Having been appropriately informed of the determination by the laboratory, the podiatric physician is able to treat the problem accordingly.

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