A medical diagnosis isn't always black and white. Indeed, it's often clouded
by shades of gray. Some diseases begin with symptoms so subtle or common that
they confound even experienced doctors. Other times, a patient knows exactly
what's wrong but can't decide which treatment is best.
Enter the second opinion. It's never a bad idea to seek a second opinion,
but if you receive one of these five diagnoses, it's practically a must.
Is everything OK down there? Could what happened to Heath Ledger
happen to me? What are the signs of dry drowning? WebMD's expert bloggers took
on some of the year's toughest issues and our readers responded.
Those topics are among the most viewed blog posts on WebMD for 2008.
What Are Those Little White Bumps?
My Ultrasound Found an Ovarian Cyst
Statins and Muscle Pain
6 Minutes to a Sharper Memory
Vaginal Discharge: N...
If you've been diagnosed with an uncommon cancer -- or if there's any
question about whether it's truly cancer -- seek a second opinion from a
pathologist who has expertise in diagnosing this type of malignancy. After all,
the diagnosis will determine which treatment is best.
"There are certain kinds of tumors that provide a lot more difficulties
in diagnosis," says John E. Tomaszewski, MD, FASCP, vice chairman of
Anatomic Pathology-Hospital Services at the University of Pennsylvania School
of Medicine. For example, sarcomas -- an uncommon cancer of soft tissues, such
as muscle or fat -- can be complex to classify. "A general pathologist may
not see a lot of soft-tissue tumors," he says.
Major medical centers that see larger numbers of rare or unusual tumors are
often a better choice for a second opinion than a smaller hospital, according
to John S.J. Brooks, MD, FASCP, president of the American Society for Clinical
Pathology. "These folks that have very rare tumors, [a hospital] near them
may only see very few," he says.
Getting that second opinion can help catch errors.
"Anytime there's uncertainty, it's always fine [to get a second
opinion]," Tomaszewski says. "Pathology ... is like every other area of
medicine. There are things that are very clear and things that are on the
2. ADHD in Children Under Age 6
With no specific lab test for attention deficit hyperactivity disorder
(ADHD), the problem can be tough to diagnose accurately. A doctor's judgment
comes into play; he or she may diagnose ADHD if a child shows hyperactivity,
inattention, and impulsivity in at least two settings, such as home and
When a child under age 6 is diagnosed with ADHD, parents may want a second
opinion from a specialist, such as a child psychiatrist, says Sara Rizvi, MD,
assistant professor of pediatrics at the Baylor College of Medicine. That's
because ADHD symptoms, such as too much talking or fidgeting, can overlap with
behavior that's typical among young children.
"Many of the symptoms are common among preschool children," Rizvi
says. "Part of it is because of their developmental stage and level of
activity and normal short attention spans." A second opinion can help
determine if symptoms are serious enough to be classified as ADHD.
It's also crucial to rule out other mental disorders that can be confused
with ADHD, according to Rizvi. These include developmental problems, learning
disabilities, anxiety, and depression. Sometimes, children who witness domestic
violence may behave in ways that suggest ADHD, Rizvi says. "They tend to be
more inattentive to their class work, more impulsive. A lot of those children
are actually misdiagnosed with ADHD when in fact they may be manifesting
symptoms of posttraumatic stress disorder."