Utilizing AI in Medicine: Case Evaluation

When consulting AI language models like ChatGPT or Google Bard for medical case evaluation, providing comprehensive and specific medical information is crucial. By offering detailed and relevant data, including imaging and laboratory studies, the AI can conduct a more precise assessment and provide suitable recommendations.

Here are some cases diagnosed by ChatGPT:

This 75-year-old man presented with complaints of headache and jaw pain.
He was correctly diagnosed but ChatGPT with Giant Cell Arteritis as noted below:

In a 75-year-old man who is experiencing new-onset headaches and pain in the jaw, it is important to consider several potential causes. Given the specific symptoms you mentioned, one condition that should be considered is giant cell arteritis (temporal arteritis). Giant cell arteritis is an inflammatory disease that primarily affects the blood vessels, especially the arteries in the head and neck region.

Giant cell arteritis often presents with the following characteristics:

  1. Headache: Persistent or throbbing headaches, often localized around the temples.
  2. Jaw pain: Pain and tenderness in the jaw muscles, particularly when chewing or talking.
  3. Scalp tenderness: The scalp may be sensitive to touch, such as when brushing the hair.
  4. Vision changes: Blurred vision, double vision, or sudden vision loss can occur if the blood vessels supplying the eyes are affected.

Other symptoms that may be associated with giant cell arteritis include fatigue, weight loss, low-grade fever, stiffness in the neck or shoulders, and general malaise.

Given the age of the individual, the new-onset nature of the headaches, and the presence of jaw pain, it is important for him to seek immediate medical attention. Giant cell arteritis is a serious condition that requires prompt evaluation and treatment with corticosteroids to prevent potential complications, including vision loss.

It is worth noting that the diagnosis of Giant Cell Arteritis below was made by chatGPT solely based on headache and jaw pain. Therefore comprehensive assessment that considers various factors, including the patient’s age, clinical presentation, and laboratory findings would easily make the diagnosis.

The 42-year-old man presented with a cough, night sweats, fatigue, and a history of uveitis.
Based on these limited symptoms provided, ChatGPT listed sarcoidosis as a second possible diagnosis:

In a 42-year-old man with a cough, uveitis, fatigue, and weight loss, several potential causes should be considered. Here are some possibilities:

  1. Tuberculosis (TB): TB is an infectious disease caused by the bacterium Mycobacterium tuberculosis. It commonly affects the lungs but can also involve other organs. Symptoms may include a persistent cough, night sweats, fatigue, and weight loss. Uveitis can be associated with TB in some cases.
  2. Sarcoidosis: Sarcoidosis is an autoimmune disorder characterized by the formation of granulomas in various organs, including the lungs, lymph nodes, skin, and eyes. It can cause symptoms such as cough, night sweats, fatigue, and uveitis.
  3. Other autoimmune disorders: Certain autoimmune conditions, such as rheumatoid arthritis or systemic lupus erythematosus (SLE), can present with symptoms like cough, night sweats, fatigue, and uveitis. These conditions involve the immune system mistakenly attacking the body’s own tissues.
  4. Other infections or systemic diseases: There are other infections or systemic diseases that could potentially cause these symptoms, including certain viral or bacterial infections, lymphoma, or other malignancies. However, it would require a comprehensive evaluation by a healthcare professional to determine the specific cause
    It’s important to note that AI can provide insights based on even limited information provided.
A 49-year-old woman presents with symptoms of lower extremity numbness, sore tongue, and difficulty with concentration.
ChatGPT correctly diagnosed with vitamin deficiency in this case a B12 deficiency as noted below:
  1. Vitamin deficiencies: Numbness in the lower extremities and a sore tongue can be symptoms of certain vitamin deficiencies, such as vitamin B12 deficiency. This can occur in individuals who follow a strict vegetarian or vegan diet, or those with malabsorption issues.
  2. Peripheral neuropathy: Peripheral neuropathy is a condition that affects the nerves outside of the brain and spinal cord. It can cause numbness, tingling, and pain in the extremities. There are various causes of peripheral neuropathy, including diabetes, certain infections, autoimmune disorders, and exposure to toxins.
  3. Multiple sclerosis (MS): MS is a chronic autoimmune disease that affects the central nervous system. It can cause a wide range of symptoms, including numbness or tingling in the limbs, fatigue, and problems with coordination. MS is more commonly diagnosed in women, but it can affect men as well.
  4. Other potential causes: Other conditions that may cause numbness in the lower extremities and a sore tongue include nerve compression or injury, certain medications, thyroid disorders, and certain infections.
A 46 year old man presents with morning headaches and fatigue.
ChatGPT correctly made the diagnosis of sleep apnea here:
  1. Sleep Disorders: Conditions such as sleep apnea, where breathing pauses during sleep, can lead to morning headaches and fatigue. Poor sleep quality or insufficient sleep duration can also contribute to these symptoms.
  2. Migraines: Migraines can cause headaches, including those occurring in the morning. They are often accompanied by other symptoms like sensitivity to light and sound.
  3. Medication Side Effects: Certain medications can cause morning headaches and fatigue as side effects. If the person is taking any medications, it would be important to evaluate their potential contribution to the symptoms.
  4. Chronic Fatigue Syndrome (CFS): CFS is characterized by persistent fatigue that is not alleviated by rest and is often accompanied by other symptoms such as headache, muscle pain, and cognitive difficulties.
  5. Stress and Anxiety: Chronic stress and anxiety can lead to headaches and fatigue. The impact of stress on sleep quality can also contribute to morning symptoms.
  6. Other Medical Conditions: There are numerous medical conditions that can cause morning headaches and fatigue, including thyroid disorders, anemia, chronic sinusitis, and neurological disorders.
A 79-year-old female patient arrives with complaints of intense low back pain following a fall she experienced two weeks prior. She sought medical attention at the emergency room where X-rays were conducted and no fractures were detected. However, her condition has not improved, prompting the need for further investigation to identify the underlying cause of her persistent pain. Which diagnostic test should be pursued next?
ChatGPT correctly recommended an MRI as noted below:

After evaluating a 79-year-old female patient who presents with severe low back pain after a recent fall, where X-rays ruled out fractures but her symptoms have not improved, the next appropriate step would be to pursue further diagnostic tests to determine the cause of her ongoing pain.

One suitable test to consider at this stage could be magnetic resonance imaging (MRI) of the lumbar spine. MRI is a valuable imaging modality that provides detailed visualization of the soft tissues, including the spinal discs, nerves, and surrounding structures.

By examining the images obtained from an MRI scan, healthcare professionals can identify potential issues such as herniated discs, spinal stenosis, or nerve impingement that may be contributing to the patient’s persistent pain. Ultimately, the decision on which specific diagnostic test to pursue should be made in consultation with a qualified healthcare provider, taking into account the patient’s medical history and clinical presentation.

After experiencing chest pain and shortness of breath, my 75-year-old mother was admitted to the intensive care unit (ICU) following her visit to the emergency room (ER). Additionally, she has been dealing with swollen legs for several months, and her mobility is limited. I’m wondering what might be causing her symptoms.
ChatGPT correctly made the diagnosis of her cardiac issue here as outlined:
  1. Cardiac Issues: The combination of chest pain, shortness of breath, and swollen legs could be indicative of heart-related problems. Conditions such as congestive heart failure, coronary artery disease, or a heart valve disorder may cause these symptoms.
  2. Pulmonary Conditions: Shortness of breath can also be a sign of lung-related issues such as chronic obstructive pulmonary disease (COPD), pulmonary hypertension, or a pulmonary embolism (blood clot in the lung).
  3. Peripheral Edema: Swelling in the legs could be due to fluid retention, which can occur in conditions such as heart failure or kidney disease.
  4. Reduced Mobility: If your mother has been unable to walk far and has had swollen legs for months, it’s possible that the lack of physical activity and prolonged sitting or immobility may contribute to leg swelling and muscle weakness.
A 36 year old woman presents with fatigue and positive ANA. What additional tests would you recommend to further evaluate this positive ANA test?
To further evaluate this positive ANA test, the following additional serological tests was recommended by ChatGPT:
  1. Anti-dsDNA (double-stranded DNA) Antibodies: This test specifically targets antibodies against dsDNA, which is highly specific for systemic lupus erythematosus (SLE). Elevated levels of anti-dsDNA antibodies can help confirm a diagnosis of SLE.
  2. Anti-Smith Antibodies: Anti-Smith antibodies are highly specific for SLE. Testing for these antibodies can provide additional support for a diagnosis of SLE if present.
  3. Anti-SSA/Ro and Anti-SSB/La Antibodies: These antibodies are associated with Sjögren’s syndrome and can also be seen in other autoimmune conditions like systemic lupus erythematosus (SLE). Testing for anti-SSA/Ro and anti-SSB/La antibodies can provide further insights.
  4. Anti-RNP (ribonucleoprotein) Antibodies: Anti-RNP antibodies are associated with mixed connective tissue disease (MCTD) but can also be found in other autoimmune conditions. Testing for these antibodies can help identify MCTD as a potential diagnosis.
  5. Rheumatoid Factor (RF): RF is an antibody that can be detected in conditions like rheumatoid arthritis (RA) and can cause fatigue. Although it is not specific to RA, testing for RF can provide additional information.
  6. Complement Levels: Complement proteins are part of the immune system and can be measured to evaluate their levels. Low levels of complement proteins, such as C3 and C4, can be seen in various autoimmune conditions.