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Updated: Jan 28, 2026
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Author Spotlight: Quantifying Pain Experience – An Illustrative Approach Using the Pain Body Diagram
Published on: July 7, 2023
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A 44-Year-Old Man with Back Pain and Weakness
John E Dobbs1, Margaret D Krasne1, Rakhi P Naik1
1from the Internal Medicine Residency Program and the Sections of Infectious Diseases, Hematology, and Pathology of Johns Hopkins Hospital.
NEJM Evidence
|January 27, 2026
Summary
This case report details a 44-year-old man with back pain and weakness. Through clinical examination and testing, a diagnosis was reached, illustrating the diagnostic process.
Area of Science:
- Internal Medicine
- Clinical Diagnostics
- Medical Education
Background:
- Morning Report is a traditional medical education exercise.
- It involves physicians-in-training presenting cases for collaborative diagnosis.
- This format facilitates learning through case-based scenarios.
Purpose of the Study:
- To present an interesting case of back pain and weakness.
- To demonstrate the process of developing a differential diagnosis.
- To illustrate how an illness script aids in reaching a final diagnosis.
Main Methods:
- A case study approach was used.
- Patient's chief concern and history were presented.
- Clinical examination, questioning, and diagnostic testing were employed.
Main Results:
- An illness script was developed for the patient's symptoms.
- The differential diagnosis was progressively refined.
- A definitive diagnosis was established based on the clinical course.
Conclusions:
- The case highlights the utility of Morning Report principles in clinical practice.
- Systematic diagnostic reasoning is crucial for complex presentations.
- Collaborative examination aids in accurate diagnosis and patient care.
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