Clinical Review

An evolving picture

BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7445.946-a (Published 15 April 2004) Cite this as: BMJ 2004;328:946
  1. F D Richard Hobbs, professor of primary care and general practice (f.d.r.hobbs@bham.ac.uk)1
  1. 1Primary Care and Clinical Sciences Building, University of Birmingham, Birmingham B15 2TT

    It is pleasing to see such a flurry of responses on bmj.com espousing the importance of incremental problem solving and of clinical acumen. This interactive case was never likely to be “typical.” As Abdullah Mohammmed comments, “the initial clinical findings seem contradictory.”1 This is so often the case with medicine, and observing symptoms and signs over time remains an essential diagnostic tool, especially in primary care. Most correspondents were …

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