The patient in "Quiz Case 2" in the February 2000 issue of the ARCHIVES1 gave a history of 6 months of nasal obstruction and 1 month of bloody rhinorrhea. Yet, in their physical examination of the patient, the authors reported only mucoid rhinorrhea and bulging of the soft palate. Unless they are not otolaryngologists, it is inconceivable that they failed to visualize such a large nasal mass. In this era of fiberoptics, a thorough assessment of the nasal cavities is possible, even in a 10-year-old child. I sincerely hope that this section of the ARCHIVES, which was started as a "Resident's Page" 4 decades ago, remains dedicated to instilling in the resident's thought process the priority of a good physical examination over any imaging study.
Deeb ZE. The Importance of a Thorough Physical Examination. Arch Otolaryngol Head Neck Surg. 2000;126(9):1169. doi: