Positive teddy bear sign

If you don't believe me, do a Pub Med search. There is something called a teddy bear sign. It is positive when a patient is found to have a teddy bear at bedside or in bed with them. It usually indicates that the patient is regressing to childhood and also has a high likelihood of non-organic disease. Of course, this only applies to adults. I don't think anyone would fault a six year old for finding comfort in stuffed animals.

However, the teddy bear isn't the only signal that your patient is going to be trouble. Here are some signs that I know of, some of which I've read about, others are my own creation.

Parents Sign is when someone over the age of 40 is found to have their parents at bedside. Always bad news and along with the teddy bear sign often represents mental and emotional regression.

Scrubs sign is when a patient in the hospital is dressed in scrubs, a sure signal that they've spent so much time in the hospital that they start requesting clothing instead of the gowns.

Retrobulbar micturalgia is a screening question used for patients with a 'positive review of systems' syndrome. You ask, "Does it hurt behind your eyes when you pee?" and if the answer is yes, your diagnosis is confirmed.

Radiology sign is when a radiologists marks an x-ray so that even an idiot internist can interpret it.

The radiographic criteria for fibromyalgia are (1) at least 2 MRI scans of spine (count each spine segment, so a CTL scan counts as three), (2) carrying the MRI films and/or reports to initial visit, (3) need for Xanax or Ativan (by name) prior to MRI and CT scans, (4) symptoms in distribution contralateral to radiographic findings. Criteria are met if 2 of 4 findings are present.

Can you think of any others? Most of these are pretty cynical and jaded, but I have to admit are good for a chuckle.


Anonymous said...

I couldn't believe it, so I did the PubMed search. And turned up this other gem:

Int J Cardiovasc Imaging. 2004 Aug;20(4):249-53.

Teddy bear in the heart.
Krishnamoorthy KM, Krishnamanohar SR.

In a patient with native aortic valve endocarditis, transoesphageal echocardiography yielded a teddy bear appearance which is not reported so far. A perivalvular abscess (right ear), the superior vena cava in cross section (left ear) and the dilated (post-stenotic) aortic root (face) made up the teddy bear. This was not a cuddlesome toy but an ominous sign. The genesis of perivalvular abscess as well as the role of transoesphageal echocardiography in its diagnosis and treatment are briefly reviewed.

"This was not a cuddlesome toy but an ominous sign." LOL

CT said...

re: Radiology sign

My seniors do this sometimes. We mark the location of infiltrates, just so that we don't have to keep reading the same films to interns/PGY1/2/3/fellows.


Anonymous said...

This is great.
here are some more for ur pleasure:

1). Boyfriend in the bed sign
or(girlfriend).. gonna be bad omen
2). teddy bear sign is a studied phenomon in adult neurology circles..
3). splitting the skull to vibration, (wont explain that one).
4). hoover's sign, and others
5). when a patient wants "Dema, Dema,....ummm something like that, it begins with a D...you know the one"
6). Worst headache in my life, in a chronic migrainer....
7). do your teeth hurt when u pee( a variation of above comment).
8). pseudo-Gegenhaltin*
9).. supratentorial, pseudo this or that, conversion disorder, malingering, and shaking and faking.... (all bread n butter neuro.
10). running on tippy toes, and saying your legs are weak

It is very difficult to trick a Neurologist...