The Unexpected Hand Patient
- PMID: 28536645
- PMCID: PMC5424442
The Unexpected Hand Patient
Abstract
Objective: Physicians should be aware of patients trying to obtain a diagnosis for secondary gain. Malingering is a diagnosis that should be suspected when objective findings do not support the subjective symptoms and there is secondary gain.
Methods: A series of 21 cases are presented that support this position. The charts of 21 patients with a diagnosis of reflex sympathetic dystrophy (chronic regional pain syndrome) and nonanatomic findings were evaluated.
Results: The patients in this series were found to be malingering based on discrepancies between subjective symptoms and objective findings.
Conclusions: The diagnosis of malingering should be based on thorough history, physical examination, electrodiagnostic studies, imaging studies, and evaluation of all medical records.
Keywords: complex regional pain syndrome (CRPS); malingering; reflex sympathetic dystrophy (RSD).
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Comment in
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The Unexpected Hand Patient: Invited Commentary.Eplasty. 2017 May 5;17:e17. eCollection 2017. Eplasty. 2017. PMID: 28616123 Free PMC article. No abstract available.
References
-
- Jewish Publication Society. Tanakh = [Tanakh]: A New Translation of the Holy Scriptures According to the Traditional Hebrew Text. 1st ed. Philadelphia: Jewish Publication Society; 1985. p. 1624. xxvi.
-
- Mendelson G, Mendelson D. Malingering pain in the medicolegal context. Clin J Pain. 2004;20(6):423–32. - PubMed
-
- American Psychiatric Association; DSM-5 Task Force. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. Arlington, VA: American Psychiatric Association; 2013. p. 726.
-
- Louis DS, Lamp MK, Greene TL. The upper extremity and psychiatric illness. J Hand Surg Am. 1985;10(5):687–93. - PubMed
-
- LoPiccolo CJ, Goodkin K, Baldewicz TT. Current issues in the diagnosis and management of malingering. Ann Med. 1999;31(3):166–74. - PubMed
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