Table 2.

Patterns of Presentation of Rare Problems

Problem PresentationClinical Examples
Low incidence or prevalence in practice populationInsulinoma
Classic presentation of a rare disorderRenal tuberculosis in asymptomatic patient with persistent sterile pyuria
Rare clinical presentationMelanoma presenting as pelvic mass
Rare clinical courseCholecystitis in a 5-month-old child
Obscure diagnosisDiagnosis of carotinemia after extensive studies by multiple consultants for jaundice
Rare coincidenceSexual assault leading to multiple sexually transmitted diseases and hydatidiform mole
Rare interventionFontan procedure for hypoplastic left ventricle syndrome
Rare complicationOvarian teratoma incarcerated in inguinal hernia
Special family contextPrenatal diagnosis in pregnant woman with adrenoleukodystrophy
Special community contextDiagnosis of pertussis identifying epidemic