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Advance Praise for Diagnosketch
This book is equally as useful to patients as it is to
doctors. The illustrations cover the most common
diagnoses in the ED and reect the diversity of
patients we see every day. Everyone will nd themselves represented here.
— Thea James, MD, EM Physician; Vice President
of Mission and Associate Chief Medical Ocer,
Boston Medical Center
Not only does Diagnosketch help patients understand their anatomy, it also gives physicians, nurses,
PAs, and others the opportunity to maximize use of
the very small amount of time they have with their
patients. With this book at the bedside, we can be
more ecient and patients leave with a better understanding of their ED visit.
— Andrew Ulrich, MD, Professor of Emergency
Medicine, Vice Chair of Operations,
Yale School of Medicine
This book is an extremely helpful tool for real- time patient education, there is really nothing available that
is comparable to Diagnosketch. It is the best resource
for concise and easy-to-understand explanations for
patients of their diagnoses, while still maintaining
medical accuracy and appropriate level of detail. It
helps me get through to my patients and makes bedside education much smoother and more meaningful.
— Celia Pagano, PA- C in Emergency
Medicine for 6+ years
As a nurse who spends a fair amount of time educating patients and their families, this book is a brilliant idea! It allows me the opportunity to impact
patients’ understanding of their disease, and is an excellent resource in triage.
— Elizabeth Gibb, BSN, RN, Emergency
Department Nurse for 41 years at the busiest EDs
in New England
I could really have used these illustrations to explain
to my patient with an ovarian cyst what was going
on! She was in the hospital with her dad and the
doctor here was a man. I had to give the poor girl a
crash course in A&P, menstruation, and explain what
was going on without scaring her to death. My artwork is subpar at best, I really wish I had this book!
— Kim Belton, RN, ER Nurse at Atrium Health with
11+ years’ experience
I use Diagnosketch not only with my patients at work,
but also to explain my job to my children at home. It’s
a fantastic teaching tool!
— Jaclyn Davis, MD, EM Physician with 10+ years’
experience and Medical Sta President, Atrium
Health Pineville
I work in a rural outpatient clinic setting and make
rough drawings on my own all day for patients on the
paper covering the tables or the back of glove boxes.
I really enjoy this book; patients nd the pictures
easy- to- understand and I like how clear they are.
— Carol Venable, MD of 20+ years, EM/ IM
Physician, Port Townsend, WA
This book replaces the need to pull up Google at the
bedside to search for images. All common diagnoses
are compiled and easy- to- understand!
— John Burger, MD, EM Physician with 10+ years’
experience in Charlotte, NC
This book is amazing! The simplicity of it, with the
wonderful illustrations, makes this an awesome
teaching tool for our patients. I can’t wait to share
this with my team.
— Rachel Smitek, MD, Senior Director of Quality,
US Acute Care Solutions; Board- Certied
Emergency Medicine doctor with 10+ years of
practice
I love this book, there are so many great visuals for
the bread and butter of what we see and explain all
of the time. What a great resource!
— Katrina Barnett, MD, On Sta, El Camino
Hospital, Mountain View and Los Gatos, CA; On
Sta, Palo Alto VA, CA; ER physician for 15+ years
Physicians are expected to provide excellent medical care; but it is equally important for them to explain diagnoses and treatments in a manner that
gives the non- medical both understanding and reassurance. Diagnosketch, by emergency physician
Dr. Sapana Adhikari, uses simple illustrations and text
to bridge the communication gap between physician and patient so that even complex issues can be
comprehended at the bedside. This will prove to be
an essential tool for every emergency department.
— Edwin Leap, MD, Emergency Physician with
30 years’ experience; Columnist
https://t.me/med1917
https://t.me/med1917
Diagnosketch
https://t.me/med1917
https://t.me/med1917
Diagnosketch:
A Visual Guide to
Medical Diagnosis for the
Non- Medical Audience
Created and Illustrated by
Sapana P. Adhikari, MD
https://t.me/med1917
Oxford University Press is a department of the University of Oxford. It furthers
the University’s objective of excellence in research, scholarship, and education
by publishing worldwide. Oxford is a registered trade mark of Oxford University
Press in the UK and certain other countries.
Published in the United States of America by Oxford University Press
198 Madison Avenue, New York, NY 10016, United States of America.
© Sapana Adhikari, MD 2022
All rights reserved. No part of this publication may be reproduced, stored in
a retrieval system, or transmitted, in any form or by any means, without the
prior permission in writing of Oxford University Press, or as expressly permitted
by law, by license, or under terms agreed with the appropriate reproduction
rights organization. Inquiries concerning reproduction outside the scope of the
above should be sent to the Rights Department, Oxford University Press, at the
address above.
You must not circulate this work in any other form
and you must impose this same condition on any acquirer.
Library of Congress Cataloging- in- Publication Data
Names: Adhikari, Sapana P., author.
Title: Diagnosketch : a visual guide to medical diagnosis for
the non-medical audience / created and illustrated by Sapana P. Adhikari.
Description: New York, NY : Oxford University Press, [2022] |
Includes bibliographical references and index. |
Identiers: LCCN 2022012638 (print) | LCCN 2022012639 (ebook) |
ISBN 9780197636954 (paperback) | ISBN 9780197636978 (epub) |
ISBN 9780197636985 (online)
Subjects: MESH: Diagnostic Techniques and Procedures |
Medical Illustration | Health Communication--methods |
Patient Education as Topic | Critical Care | Pictorial Work
Classication: LCC RC71.3 (print) | LCC RC71.3 (ebook) | NLM WB 17 |
DDC 616.07/5—dc23/eng/20220525
LC record available at https://lccn.loc.gov/2022012638
LC ebook record available at https://lccn.loc.gov/2022012639
DOI: 10.1093/ med/ 9780197636954.001.0001
9 8 7 6 5 4 3 2 1
Printed by WebCom, Inc., Canada
is material is not intended to be, and should not be considered, a substitute for medical or other professional advice. Treatment for the
conditions described in this material is highly dependent on the individual circumstances. And, while this material is designed to oer
accurate information with respect to the subject matter covered and to be current as of the time it was written, research and knowledge
about medical and health issues is constantly evolving and dose schedules for medications are being revised continually, with new side
eects recognized and accounted for regularly. Readers must therefore always check the product information and clinical procedures
with the most up- to- date published product information and data sheets provided by the manufacturers and the most recent codes of
conduct and safety regulation. e publisher and the authors make no representations or warranties to readers, express or implied, as to
the accuracy or completeness of this material. Without limiting the foregoing, the publisher and the authors make no representations or
warranties as to the accuracy or ecacy of the drug dosages mentioned in the material. e authors and the publisher do not accept, and
expressly disclaim, any responsibility for any liability, loss, or risk that may be claimed or incurred as a consequence of the use and/ or
application of any of the contents of this material.
Mayo Foundation does not endorse any particular products or services, and the reference to any products or services in this book is for
informational purposes only and should not be taken as an endorsement by the authors or Mayo Foundation. e incidental appearance
of brand names on any equipment or the mention of brand names in the narration in the accompanying videos has been avoided when at
all possible; any occurrences were le to preserve the educational integrity of the videos and should not be taken as endorsement by the
authors or Mayo Foundation. Care has been taken to conrm the accuracy of the information presented and to describe generally accepted
practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application
of the information in this book and make no warranty, express or implied, with respect to the contents of the publication. is book should
not be relied on apart from the advice of a qualied health care provider.
https://t.me/med1917
Contents
Introduction ix
About the Author/ Illustrator xiii
1 Skin 01
Blood draw 02
IV: Intravenous insertion 03
Cut: Laceration 04
Options for repair 05
Boil: Abscess 06
MRSA: Methicillin- resistant Staphylococcus aureus 07
Paronychia 08
Crushed nger: Subungual hematoma 09
Supercial clot: Supercial thrombophlebitis 10
Airway anatomy 11
2 EENT (eye, ear, nose, throat) 13
Eye pain: Corneal abrasion & conjunctivitis 14
Toothache: Dental caries vs dental abscess 15
Nosebleed: Epistaxis 16
Sinus infection: Sinusitis 17
Inner ear infection: Otitis media 18
Swimmer’s ear: Otitis externa 19
Sore throat: Strep pharyngitis & peritonsillar
abscess (PTA) 20
3 Cardiopulmonary 21
Bronchitis vs pneumonia 22
Emphysema: Chronic obstructive pulmonary
disease (COPD) 23
Blood clot: Deep vein thrombosis (DVT) &
pulmonary embolism (PE) 24
Swollen legs: Pedal edema 25
Heart attack: Myocardial infarction (MI) 26
Chest pain evaluation 27
Heart failure: Congestive heart failure (CHF) 28
Heart failure causes: Diastolic vs systolic disease 29
High blood pressure: Hypertension (HTN) 30
HTN+Symptoms: Hypertensive urgency 31
Irregular heart beat: Atrial brillation 32
Fluid around heart: Pericarditis vs pericardial
eusion 33
Aortic dissection 34
Aortic aneurysm 35
Poor circulation: Peripheral artery disease &
venous insuciency 36
4 Gastrointestinal 37
Digestion 38
Abdominal pain 39
Heartburn: Gastroesophageal reux disease
(GERD) 40
Gastritis & ulcer 41
Vomiting blood: Upper gastrointestinal bleed
(UGIB) 42
Rectal bleed: Lower gastrointestinal bleed (LGIB) 43
Hiatal hernia 44
Hernia: Normal vs incarcerated 45
Foreign body in esophagus: Esophageal stricture 46
Bowel blockage: Small bowel obstruction (SBO) 47
Gallbladder disease: Biliary colic 48
Pancreatitis 49
Diverticular disease: Diverticulosis,
diverticulitis, & perforation 50
Constipation 51
Perirectal abscess 52
Hemorrhoids 53
Appendicitis 54
5 Genitourinary 55
Nephrolithiasis 56
Cystitis vs pyelonephritis 57
Enlarged prostate: Benign prostatic
hypertrophy (BPH) 58
Urinary retention 59
Testicular swelling: Epididymitis 60
Testicular swelling: Hydrocele vs varicocele 61
Testicular torsion 62
Ovarian torsion 63
viii Contents
https://t.me/med1917
Ovarian cyst: Normal cyst vs ruptured cyst 64
Early pregnancy: Abdominal pain &/ or vaginal
bleeding 65
Fibroids: Leiomyoma 66
Irregular periods: Abnormal uterine bleeding 67
Yeast infection: Vaginal candidiasis 68
Vaginal discharge: Bacterial vaginosis 69
Pelvic infection: Pelvic inammatory disease
(PID) & tubo- ovarian abscess (TOA) 70
Sexually transmitted infection 71
Lower abdomen: Male vs female 72
6 Orthopedics 73
Broken: Fracture 74
Growth plate injury 75
Arthritis: Degenerative joint disease 76
Bursitis 77
Rib fracture 78
Collapsed lung: Pneumothorax 79
Back pain: Musculoskeletal 80
Back pain: Sacroiliitis 81
Back pain: Side view 82
Sciatica: Lumbar radiculopathy 83
Neck pain: Cervical strain 84
Neck & back strain: Motor vehicle accident (MVA) 85
Knee arthritis: Osteoarthritis 86
Knee pain: Fracture vs sprain 87
Joint disease: Normal anatomy 88
Inamed joint: Gout vs septic joint 89
Baker’s cyst 90
Ankle pain: Fracture vs sprain 91
Wrist pain: Carpal tunnel syndrome 92
Foot pain: Plantar fasciitis 93
Broken back: Compression fracture 94
7 Neurology 95
Stroke: Cerebral vascular accident (CVA) 96
Mini-Stroke: Transient ischemic attack (TIA) 97
Brain bleed: Intracranial hemorrhage (ICH) 98
Brain aneurysm: Subarachnoid hemorrhage
(SAH) 99
Meningitis 100
Dizziness: Benign positional vertigo (BPV) 101
Bell’s palsy: 7th cranial nerve palsy 102
Concussion: Closed head injury 103
8 Miscellaneous 105
Cancer: Diagnosis & work- up 106
Diabetes: Diabetes mellitus type 2 107
Alternating medications: Fever control or pain
control 108
Bacteria vs virus 109
Code status 110
Scripting 111
Index 127
https://t.me/med1917
INTRODUCTION
D
cated anatomy and concepts. e title, Diagnosketch,
combines the term “diagnosis” with the term “sketch,”
paralleling the way the book combines a medical diagnosis with a simplied sketch. It includes common
pathologies seen in an acute care setting, especially ones
that are easier to explain with pictures.
anatomy and common medical diagnoses. Research
from the US Department of Education estimates that
only 12% of English- speaking adults in the United
States have procient health literacy skills.1 Studies indicate that almost 90% of adults have diculty understanding health information that is currently available.2
ese patients are oen unequipped to make important
decisions about their own health care.
non- medical population. It simplies human anatomy
and pathophysiology into memorable, understandable images. It relies on the concept of “picture superiority eect.” e picture superiority eect states that
HEARING information will lead to 10% retention of
the content, but HEARING and SEEING information
leads to 65% retention of content. Diagnosketch not
only explains dicult concepts to patients, but also
helps patients remember them.
ical professionals use with every patient at the bedside.
Excellent medical care involves diagnosing and treating
disease, but just as importantly, communicating well
with patients. Diagnosketch helps achieve this goal.
iagnosketch is a visual aid to explain medical diagnoses to patients at the bedside. It
uses simplified images to illustrate compli-
Many American patients are unfamiliar with human
Diagnosketch improves health care literacy for the
Diagnosketch serves as the visual guide that med-
KEY COMPONENTS OF DIAGNOSKETCH
Simplicity
e images in the book intentionally simplify information to help educate a non- medical audience. e
images leave out details that may not be clinically relevant and overemphasize those that are. Although the
general anatomy is correct, certain organs are exaggerated. For example, the gallbladder is quite small in the
human abdomen, yet in the images, it is depicted much
larger to emphasize its clinical relevance. Also, human
physiology has been simplied with colors. For example, in some images blood vessels are depicted in red
whether they carry oxygenated or deoxygenated blood.
In addition, the images intentionally leave out smaller
anatomical structures (like nerves and smaller blood
vessels) for simplicity’s sake.
Practicality
e images in the book depict only the most common
diagnoses seen in an acute care setting and only those
that would benet from an image. In busy settings,
sometimes the health care encounter lasts just a few
minutes. Diagnosketch presents a simple, clear image
that improves understanding as quickly and eciently
as possible. In addition, the labels are minimal and
are written in colloquial, non- medical language. is
encourages the patient to listen to the explanation from
the medical professional, rather than read and become
confused by complicated medical terminology.
1 Kutner, M., Greenberg, E., Jin, Y., & Paulsen, C. (2006). e Health Literacy of America’s Adults: Results From the 2003 National Assessment of Adult
Literacy (NCES 2006- 483). Washington, DC: US Department of Education, National Center for Education Statistics.
2 US Department of Health and Human Services, Oce of Disease Prevention and Health Promotion. (2010). National Action Plan to Improve Health
Literacy. Washington, DC: Author.
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