What are the traditional findings of pneumonia?
Increased tactile fremitus
Dullness to percussion
Bronchial breath sounds with late-inspiratory crackles
Egophony
Yet findings are often scanty or even absent. This argues against the original claims of physical diagnosis founders, that the bedside exam could identify any patient with pneumonia. The reason for this discrepancy is that modern physical exam is judged against extremely sensitive gold standards, such as roentgenograms and CT scans. Conversely, the 19th century gold standard was autopsy, which selected the most severe forms of pneumonia, and thus the ones more likely to be associated with abnormal physical findings.
Increased tactile fremitus
Dullness to percussion
Bronchial breath sounds with late-inspiratory crackles
Egophony
Yet findings are often scanty or even absent. This argues against the original claims of physical diagnosis founders, that the bedside exam could identify any patient with pneumonia. The reason for this discrepancy is that modern physical exam is judged against extremely sensitive gold standards, such as roentgenograms and CT scans. Conversely, the 19th century gold standard was autopsy, which selected the most severe forms of pneumonia, and thus the ones more likely to be associated with abnormal physical findings.