ABSTRACT
A patient’s hands can provide a wealth of information relevant to the diagnostic process. However, the strategies described are equally applicable to any part of the clinical examination. The patients have been selected to demonstrate a spectrum of approaches used in clinical reasoning. They demonstrate the process of forming a diagnostic hypothesis including the intuitive spot diagnosis based on a single clinical cue, and more sophisticated pattern recognition. The more complex cases lead to a consideration of the various refinement strategies including restricted rule out, pattern fit recognition and deliberate reasoning. The first section addresses strategies that can be used when taking a history, and the second strategies used when examining patients.
