diagnstico (sindrmico,

anatmico, topogrfico,
etiolgico e diferencial).
It is good practice to form a symptomatic/anatomic/etiologic diagnosis for each pain problem. This practice
eliminates jumping to a syndromic conclusion and serves as framework for an orderly approach to the problem.
This approach is demonstrated by the following cases.
Case 1
A 36-year-old woman developed diffuse neck pain without an antecedent history of illness or injury. The pain was
deep and gnawing and was accompanied by sharp pain down the radial aspect of her arm and forearm to the
thumb inde! and middle fingers. It was accompanied by a deep boring "worse at night# intrascapular pain and
mild weakness of the right biceps muscle. $he had mild numbness of the thumb. %!amination revealed limited
range of motion of the cervical spine to the right and a right $purling sign "pain reproduced by e!tension and lateral
rotation to the right#. $he had mild weakness of the right biceps and brachialis a diminished right &
Iniciando pelo processo de estabelecimento de um diagn'stico ( poss)vel falar em diagn'sticos* sindr+mico
anat+mico ou topogr,fico e etiol'gico. - primeiro sindr+mico parte da observa./o de sinais e sintomas.
$intomas s/o descri.0es do paciente e sinais s/o observa.0es do m(dico verific,veis no paciente. %m outras
palavras 1uando o paciente chega ao consult'rio e perguntado pelo m(dico sobre 2o 1ue se passa3 2o 1ue
sente3 ele relata suas dores seu estado