As a doctor, it’s not easy to admit that doctors are sometimes wrong about a diagnosis. It’s even harder for a patient to question their doctor’s diagnosis when treatment they’ve suggested isn’t working or what they’ve told you just doesn’t seem to ring true for you. That said, there are some illnesses and conditions, however, that are very similar to each other and can present identical symptoms that can be misjudged by your doctor. In fact, there are several conditions, that I’d like to talk to you about, that can get misdiagnosed in men.
Commonly Misdiagnosed Ailments
Meniscus Tears: Like many of my active male patients, you may like to play sports and may find yourself with some sharp and/or chronic pain around your knee. MRI’s can usually pick up a tear in the meniscus but sometimes do not and some doctors want to do surgery anyway to go in and look. Many times, however, pain around the knee can be a result of friction/inflammation in the ilio-tibial band that extends from the hip to the knee.
Recommendation: Unless a specific tear shows up on MRI, try a course of physical therapy, anti-inflammatories, and special shoe orthotics before consenting to surgery on your knee. See if the knee pain resolves itself.
Allergies: Many symptoms get routinely classified under the broad heading of “allergy” and many doctors fall back on that as a catch-all diagnosis. They may give you an allergy prescription or suggest over the counter allergy medications. These may help with some of the symptoms but if your condition persists, you may actually have “vasomotor rhinitis” which is a chronic inflammation of the nasal tissues. This condition becomes aggravated by smells like laundry soap, perfume, car exhausts, glues, etc.
Recommendation: If you’ve never had allergies as a child, it’s not likely you developed them later in life. To be sure, though, get a skin test given by an Allergy and Immunologist doctor. Some allergy could have been overlooked as a child and you didn’t know it. If your test comes up negative, you and your doctor will need to look at whether rhinitis, or some other condition, is causing your symptoms.
Fibromyalgia: Men do get fibromyalgia, but because it occurs more frequently in women, the diagnosis in a man is usually the last consideration although you may have all the typical symptoms.
Recommendation: See a doctor who is a fibromyalgia specialist and will look at your symptoms instead of statistics of typically male and female illnesses.
Sinus Headache: Some of my patients routinely say, “Oh, my sinus headaches are acting up in this weather” as their headaches may sometimes coincide with outdoor weather, or inside environmental, changes that can aggravate sinus congestion and headaches. However, on further probing, it was found that some of them actually were having migraine headaches which frequently do not respond to the same treatment as sinus headaches.
Recommendation: Keep track of when your headaches are occurring and what seems to aggravate them (light, sound, smells, medications you take, food you eat, etc), and what, if anything, relieves them. If your headaches recur on a regular basis and only partly seem related to climate or environmental (indoor air conditioning, heat, humidity etc) changes, see a neurologist for further evaluation of them.
Gynecomastia: Some men develop more ample breast tissue than usual. This can often be due to intake of dietary estrogens or a testosterone deficiency. However, gynecomastia is sometimes diagnosed in lieu of what may really be the issue, breast cancer, as, again, breast cancer is typically a female illness.
Recommendation: If your breast tissue seems enlarged to you, and/or feels firmer than usual on touch, see a doctor who specializes in breast cancer, as the disease can occur in men as well.
Appendicitis: ER’s around the country are filled with guys coming in the middle of the night complaining of sharp pain in their right lower abdomen. The first thought for most ER doctors and health care personnel is appendicitis. Because acute appendicitis can be life-threatening if the inflamed/infected appendix is not removed quickly, a patient may be rushed to surgery only to find out that the appendix is not the issue. In fact, a recent study has shown that 16% of appendectomies did not need to be done.
Recommendation: Before consenting to surgery, ask if your white cells are highly elevated first (over 10,000 ml) and if so ask for a CAT scan of your abdomen to first determine if it truly is appendicitis.
Bronchitis: In the winter months, some of my male patients come down with bronchitis which is an infection/inflammation of the “bronchioles” of the lungs. This causes coughing and wheezing and can produce a lot of yellow-to-greenish phlegm. You may sometimes need antibiotics to treat the infection. Usually bronchitis clears within 2-3 weeks but the cough may hang on as long as 6 weeks. If, however, you have these symptoms recurrently, you may actually be experiencing asthmatic flares from a virus, or dust mite, mold, animal dander, chemical, etc, allergens.
Recommendation: See a pulmonary specialist who will do some lung function capacity tests on you. In addition, pulmonary doctors work closely with Allergy and Immunology doctors to determine if a patient has any hidden allergies which may be triggering their asthma flares.
Doctors rely heavily on lab tests, x-rays, CAT scans, and other tests to obtain a diagnosis. If there is lab error or misinterpretation in the test findings, this can lead a doctor to make a wrong diagnosis. As a patient, you may wind up both getting the wrong treatment, or no treatment for your condition, which can waste precious time and cost you your health. Most patients want to remain loyal to their doctors, but if your symptoms persist even after re-visiting the issue again with your doctor, seek a second professional opinion.
Mark Rosenberg, M.D.