Differential Diagnosis

How to Come Up with a Differential Diagnosis

5 Steps to generating a differential diagnosis.

The Differential Diagnosis Grid

To come up with a thorough differential diagnosis, use the differential diagnosis grid. Use an anatomic framework plus a Mnemonic like VINDICATED MEN. Put anatomic location on one axis and the different diseases (elicited by VINDICATED MEN) on the other axis.

Rule out Worst Case Scenario

Rule out the worst case scenario.

Differential Diagnosis of the Top 100 Complaints in Primary Care


DDx to write.

  • Neck Pain
  • Neck mass
  • Knee Pain
  • Back Pain
  • Hip Pain
  • Foot and ankle pain
  • Hand pain
  • Monoarthritis
  • PMR
  • Elbow Pain
  • Foot Pain
  • Weakness
  • SOB (Dyspnea)
  • Elevated Creatinine
  • Jaundice
  • Elevated liver enzymes (mild vs. gross elevation)


Good resources

Dr. John Ey’s Differential Diagnosis list, well organized:  http://pie.med.utoronto.ca/DC/
Academic Medicine: March 2011 – Volume 86 – Issue 3 – p 307-313
Diagnostic checklist by Dr. Ely (PDF)
Preventing Diagnostic Errors in Primary Care

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