Step 3: Generate a Differential Diagnosis

Objective :

Use a Diagnostic Sieve to generate a differential diagnosis list

Diagnostic sieves are a valuable and efficient way of assessing a patient's symptoms and signs to reach a diagnosis.

Click on the categories that are relevant to this case. Correct answers are highlighted in green.


The mass in the breast combined with enlarged lymph nodes make a neoplasm a definite possibility. The pain in the right hip without any history of trauma also points toward this diagnosis.

Degenerative / Deficiency

The pain and inability to weight bear on the right hip without any history of trauma could be caused by a fracture due to osteoporosis.


Hearing the crack is highly suggestive the bone has fractured. But the trauma is very minor, so you have to be suspicious something else is going on too.

Next Step

Open ended questions establish which symptoms are most important to the patient and promote good rapport.