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Pathognomonic

[puh-thog-nuh-mon-ik]
Pathognomonic (often misspelled as pathognomic and sometimes as pathomnemonic) is an adjective of Greek origin (παθογνωμονικό [σύμπτωμα]), often used in medicine, which means diagnostic for a particular disease. A pathognomonic sign is a particular sign whose presence means, beyond any doubt, that a particular disease is present. It is derived from the Greek páthos (πάθος, disease) and gnōmon (γνώμον, "judge"). Labelling a sign or symptom "pathognomonic" represents a marked intensification of a "diagnostic" sign or symptom.

While some findings may be classic, typical or highly suggestive in a certain condition, they may not occur uniquely in this condition and therefore may not directly imply a specific diagnosis. A pathognomonic finding on the other hand allows immediate diagnosing, since there are no other conditions in the differential diagnosis. A pathognomonic sign or symptom can sometimes be absent in a certain disease, since the term only implies that when it is present, the doctor instantly knows the patient's illness.

Singular pathognomonic signs are relatively uncommon. Examples of pathognomonic findings include Koplik's spots inside the mouth in measles, the palmar xanthomata seen on the hands of people suffering from hyperlipoproteinemia, or a tetrad of rash, arthralgia, abdominal pain and kidney disease in a child with Henoch-Schönlein purpura.

Pathognomonic signs

None or very few of the examples here are pathognomonic in the true sense of the word. For example, Parkinsonism is not only seen in Parkinson's disease.
Disease Sign
Duchenne's Muscular Dystrophy Gowers' sign
Hypocalcemia Trousseau sign and Chvostek sign
Tetanus Risus sardonicus
Liver cirrhosis Spider angioma
Systemic Lupus Erythematosus Butterfly rash
Bulimia Nervosa Chipmunk facies (parotid gland swelling)
Leprosy Leonine facies (thickened lion-like facial skin)
Measles Koplik's spots
Diphtheria Pseudomembrane on tonsils, pharynx and nasal cavity
Grave's disease New bilateral Exophthalmos
Pancreatitis Cullen's sign (bluish discoloration of umbilicus)
Chronic hemorrhagic pancreatitis Grey-Turner's sign (ecchymosis in flank area)
Cholera Rice-watery stool
Typhoid fever Rose spots in abdomen
Meningitis Kernig's sign and Brudzinski's sign
Cholecystitis Murphy's sign (pain on deep inspiration when inflamed gallbladder is palpated)
Angina pectoris Levine's sign (hand clutching of chest)
Patent ductus arteriosus Machine-like murmur
Parkinson’s disease Pill-rolling tremors
Whipple's disease Oculo-Masticatory Myorhythmia
Rib fracture Pain produced with attempts to sleep on one's back
Acute Myeloid Leukemia Auer rod
Multiple Sclerosis Bilateral internuclear ophthalmoplegia
Third heart sound Congestive heart failure
Pericardial friction rub Pericarditis

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