Bone scan using (99m)Tc-MDP is the most accurate and reliable method for the early detection of fracture, and that is the screening procedure of choice for the demonstration of bone metastases. It is well known that it has superior sensitivity to radiography for this purpose. We report the case of 41 years old man with known primary tumor and metastatic vertebral fracture presenting false negative bone scan finding.
False Negative Reactions ; Mass Screening ; Neoplasm Metastasis ; Spinal Fractures

Frozen section diagnosis is a highly useful method of diagnosis. There were 4434 frozen sections, 24 false positive diagnosis, 65 false negative diagnosis and 30 deferred diagnosis. This method achieves the highest accuracy when there is a cooperation between experienced surgeon and reliable and careful pathologist. It is wise to defer the diagnosis of consult to other pathologist in difficult situation.
Biopsy/*standards ; False Negative Reactions ; False Positive Reactions ; *Frozen Sections ; Humans ; *Microtomy ; Neoplasms/*diagnosis/pathology ; *Predictive Value of Tests

Rupioid syphilid is a type of pustular syphilis which accounts for <2% of cases of secondary syphilis. In pustular syphilis, pustules undergo central necrosis giving rise to "limpet-like" crusts resembling an "oyster shell." When the clinical findings are atypical, a diagnosis is made based on serologic testing. The prozone phenomenon occurs in <1% of patients with primary or secondary syphilis. This is a false negative reaction that occurs when very high antibodies in the serum prevent the formation of the antibody-antigen lattice needed to visualize a flocculation reaction. We report a case of rupioid syphilid in a pregnant woman accompanied by the prozone phenomenon. An accurate diagnosis was delayed because of atypical clinical findings and false-negative serologic results.
Antibodies ; False Negative Reactions ; Female ; Flocculation ; Humans ; Necrosis ; Pregnant Women ; Serologic Tests ; Syphilis ; Syphilis, Cutaneous

BACKGROUND AND OBJECTIVES: The open surgical biopsy (OSB) of neck lymph nodes is considered a definite diagnostic procedure; however, the diagnostic accuracy of this procedure has not been fully studied. Thus, we aimed to identify the false negative rates of OSB for malignancy and the possible causes of misdiagnosis that might severely affect patient prognosis. SUBJECTS AND METHOD: We extracted the data from 495 OSB of neck lymph nodes between 2005 and 2012. The diagnostic accuracy of OSB of neck lymph nodes was estimated based on re-biopsy. In addition, we reviewed possible clinical factors related to false negativity, cause of misdiagnosis and its clinical impacts. RESULTS: The false negative rate of OSB of neck nodes was 2.2% with a risk of 3.8% false diagnosis among subjects with initial 'benign' results. The cases of the initial misdiagnosis (n=7) had the dismal outcomes (4 deaths, 1 disease progression). The main cause of misdiagnosis was the failure to target the disease-affected lymph nodes (85.7%). Malignancy-related symptoms persisted in all cases of misdiagnosis, which required re-biopsy. CONCLUSION: Accurate targeting of lymph nodes, close monitoring of clinical symptoms and comparison of biopsy results with symptoms are very important to reduce false negativity for malignancy in OSB of neck lymph nodes.
Biopsy* ; Diagnosis ; Diagnostic Errors ; False Negative Reactions ; Humans ; Lymph Nodes* ; Neck* ; Prognosis

Enzyme-Linked Immunosorbent Assay ; False Negative Reactions ; Gold Colloid ; HIV Antibodies ; blood ; Humans

OBJECTIVETo study the value of prenatal ultrasound in the diagnosis of fetal malformations.

METHODSWe retrospectively analyzed the clinical data of 993 cases of neonates and induced babies with malformations who were labored in our hospital from January 1999 to October 2006.

RESULTSThe incidence rate of fetal malformation was 22.5 per thousand in our study group. The detection rate of prenatal ultrasound was 79.02% (1 062/1 344), among which the detection rate of the severe malformations (87.58%, 860/982) were significantly higher than that of the minor malformations (55.80%, 202/362) (P < 0.005). The false negative rate was high for the extremity malformations (39.46%) and facial malformations (31.91%), especially the acrosclerodermas, simple cleft palates, and ear deformities.

CONCLUSIONPrenatal ultrasound is sensitive for fetal severe malformations, while the detection rate is low for fetal minor malformations.

Congenital Abnormalities ; diagnostic imaging ; False Negative Reactions ; Humans ; Retrospective Studies ; Ultrasonography, Prenatal

OBJECTIVE: To analyze the false-negative proportion and reasons of positioning test in benign paroxysmal positional vertigo (BPPV). METHOD: Sixty-eight cases were reviewed and analyzed during February to April 2009. All patients had typical clinical history of BPPV and diagnosed by positioning test,and all were treated with PRM successfully. If positioning test at the first time were negative, examinations repeated after either head shaking or return visits. RESULT: Thirteen patients (19.12%) appeared false-negative in positoning test, and 11 cases showed typical nystagmus after head shaking,while 2 cases were diagnosed by return visitis the next day. There were no statistically difference between false-negative group and positive group in age (P > 0.05), gender (P > 0.05), course of disease (P > 0.05) and types of semi-circular canal (P > 0.05). CONCLUSION Re-examinations after head shaking or return visits are useful for the diagnosis in the suspected BPPV patients who have negative positioning test.
Benign Paroxysmal Positional Vertigo ; diagnosis ; therapy ; False Negative Reactions ; Humans ; Patient Positioning

The diagnosis of human hydatidosis is primarily made using radiological and serological methods. Radiological methods are generally of low specificity and serological methods lack sensitivity, especially for pulmonary disease. In this study the capabilities of a new rapid test, the hydatid antigen dot immunobinding assay (HADIA), which was developed for the diagnosis of pulmonary hydatidosis, were studied and compared with another immunodiagnostic method, indirect hemagglutination (IHA). The study subjects included 18 patients, 9 women, 9 men; range 7 to 63 years; mean 30 years, with surgically proven pulmonary hydatidosis, a control group comprised of 14 patients; viral respiratory infections (1), cirrhosis (2), connective tissue disease (2), taeniasis (3), and 6 healthy donors. We found that the HA-DIA test had a sensitivity of 67% and specificity of 100%, and that the IHA test had a sensitivity of 50% and specificity of 100%. We conclude that HA-DIA is a simple, rapid, low cost assay that does not require instrumentation and has a higher sensitivity than IHA for the diagnosis of pulmonary hydatidosis.
Adolescent ; Adult ; Antibodies, Helminth/*blood ; Child ; Echinococcosis, Pulmonary/*diagnosis ; False Negative Reactions ; False Positive Reactions ; Female ; Humans ; Immunoblotting/*methods ; Male ; Middle Aged ; Sensitivity and Specificity

OBJECTIVETo compare the applicability of the three diagnostic criteria for metabolic syndrome (MS) proposed by the International Diabetes Federation (IDF) in 2005, Adult Treatment Panel III of National Cholesterol Education Program (NCEP-ATP III) in 2005 and Chinese Diabetes Socie (CDS) in 2004.

METHODSBased on the findings of cohort study of multiple metabolic disorders and metabolic syndrome (1971 cases) in Jiangsu province, MS was diagnosed according to these three definitions respectively, and by calculating the sensitivity, specificity, and ROC curve distance, those with lower false positive and false negative rates were identified as to detecting cardio vascular diseases (CVD) and type 2 diabetes mellitus (T2DM). While, through Cox regression analysis, to compare their relative risk (RR) and 95% confidential interval (CI) was wade.

RESULTSAmong three diagnostic criteria, the specificity by CDS of MS was higher than the other criteria (83.52%, 76.36%, 89.57%; 85.02%, 78.67%, 92.28%), however the sensitivity of CDS of MS was low (40.82%, 29.47%). When using CDS, over 50 percent of diagnosis might be missed. ATP III definition corresponded to the shortest distance in ROC curve, namely, at the diagnostic criteria, the rates of false positive and false negative for identifying clustering of CVD and T2DM were minimum (0.4369; 0.5777). The incidence of CVD [5.59 (2.62 - 11.92) vs 2.90 (1.41 - 5.93)], T2DM [3.36 (1.92 - 5.79) vs 1.97 (1.16 - 3.34)] was significantly higher in cases of ATP III+/IDF-than ATP III+/IDF+, as compared with ATP III-/IDF-.

CONCLUSIONAmong three diagnostic criteria, the ATP III definition of the MS should be the most applicable diagnostic criteria for MS in Jiangsu population.

China ; Diabetes Mellitus, Type 2 ; diagnosis ; Diagnostic Techniques, Endocrine ; standards ; False Negative Reactions ; False Positive Reactions ; Humans ; Hypertension ; diagnosis ; Metabolic Syndrome ; diagnosis ; Reference Standards ; Sensitivity and Specificity

Nocturnal penile tumescence has been proposed as a source of objective data in the evaluation of erectile capacity and clinically important in differentiating between psychogenic and organic impotence. However, the absence of sleep information and difficult differentiation of movement artifact leads to false positive or false negative reaction when portable home monitor is used. This can be overcome by polysomnographic monitoring. In addition, sleep disorders affecting nocturnal penile tumescence also could be screened. Herein, we conducted a study to investigate the significance of polysomnographic nocturnal penile tumescence monitoring in 45 men with erectile dysfunction. The nocturnal penile tumescence data from polysomnographic method were compared with those from portable method, based on the results from standard method. The results obtained were summarized 1. Polysomnographic method showed higher sensitivity(82%), lower false positive(20%) and false negative rate(16%) than portable method (71%, 30%, 28%, respectively) in the differential diagnosis of impotence. 2. Among 10 patients, with measuring of air flow monitoring and anterior tibialis EMG one patient had periodic leg movement. 3. Statistically, parameters of total REM time, total tumescence time/total sleep time, number of maximum tumescence episodes, amount of maximum tumescence episodes, T-up and T-max phase in maximum tumescence episodes, circumferential changes in maximum tumescence episodes, and rigidity in maximum tumescence episodes were found to be significantly decreased in organic impotence group. These results reflect that polysomnographic NPTM provides more validity than portable NPTM on the outcome of the differential diagnosis of impotence, and it would contribute to screening of occult sleep disorders and to study for their characteristics in association with impotence.
Artifacts ; Diagnosis* ; Diagnosis, Differential ; Erectile Dysfunction* ; False Negative Reactions ; Humans ; Leg ; Male ; Mass Screening ; Penile Erection* ; Sleep Wake Disorders