Perception is influenced by the situation

Quick information

A 73-year-old patient had a diagnosis of breast cancer with disseminated bone metastases. She went to the hospital because a general clinical deterioration. When she was going to be transferred to a bed from the ambulance she felt a strong pain in her left shoulder and a sound like a “click”.

Clinical evolution

The physical examination showed an asymmetry between both shoulders, with a lump on the left side , painful , without erythema.

The first clinical judgment of the physician in charge was a  clavicle  fracture.  We will show here the enlarged view of the picture:

The physician was not convinced about her diagnosis and she asked for the help of another colleague . The other doctor said that he saw  something in  the clavicle, probably a fracture, but he was not sure about his opinion.

The final diagnosis was detailed in the radiological report : humerus head dislocation


Final comment

When you focus on your first diagnosis, especially if it is based on an image, it may be that everything you do is aimed at confirming your impression and you can forget the rest of the images, a situation known as confirmation bias.

Confirmation bias is the tendency to search for, interpret, favor, and recall information in a way that confirms or supports one’s prior beliefs or values.(Wikipedia)