Skip to Main Content

++

Probability diagnosis

++

Geographic tongue (migratory glossitis)

++

Atrophic glossitis

++

Trauma (bites, teeth, hot food/drink)

++

Aphthous ulceration

++

Herpes simplex virus (children)

++

Fissured tongue

++

Disorders not to be missed

++

Cancer

++

HIV

++

Pitfalls (often missed)

++

Anaemia: iron, vitamins B6 and B12, folate deficiency

++

Glossopharyngeal neuralgia

++

Lichen planus

++

Fissured tongue (rarely causes soreness)

++

Median rhomboid glossitis

++

Hand, foot, mouth infection

++

Behçet syndrome

++

Crohn disease

++

Coeliac disease

++

Masquerades checklist

++

Depression

++

Diabetes (Candida)

++

Drugs (mouthwashes, aspirin)

++

Anaemia (various)

++

Is the patient trying to tell me something?

++

Possible with glossodynia.

++

Key clinical features

++

Enquire about trauma, dental problems, nutrition, drugs and associated general symptoms. The cause is usually obvious upon examination but there are some obscure cancers. The causes are similar to that of a sore throat or mouth. Investigation may include:

++

  • FBE

  • serum vitamin B12, folate and ferritin levels

  • swab and biopsy of a suspicious lesion.

++

Diagnostic tips

++

  • Look for evidence of trauma, especially from a sharp tooth or dentures.

  • When taking a history, take note of self-medications, especially sucking aspirin, a history of skin lesions (e.g. lichen planus) and consider underlying diabetes or other immunosuppression.

  • Any non-healing or chronic ulcer requires urgent referral.

  • Glossodynia (painful tongue) characteristically presents with a burning pain on the tip of the tongue, without physical signs.

  • Consider depressive illness as an underlying cause.

  • Shared care with a dental or oral medical specialist is important.

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

Murtagh Collection Full Site: One-Year Subscription

Connect to a suite of general practice resources from one of the most influential authors in the field. Learn the breadth of general practice, including up-to-date information on diagnosis and treatment, as well as key clinical skills like communication.

$145 USD
Buy Now

Pay Per View: Timed Access to all of Murtagh Collection

48 Hour Subscription $34.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.