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. 2017 May 5:17:e16.
eCollection 2017.

The Unexpected Hand Patient

Andrew M Swiergosz  1 , Morton L Kasdan  1 , Bradon J Wilhelmi  1
Affiliations

The Unexpected Hand Patient

Andrew M Swiergosz et al. Eplasty. .

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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Figures

Figure 1. Case 1
Figure 1. Case 1
The nonanatomic position present at the time of the patient's evaluation.
Figure 2. Case 2
Figure 2. Case 2
The fixed posture of the digits of the left hand.
Figure 3. Case 3
Figure 3. Case 3
The patient claimed that her right hand could not be moved from the position shown in the artwork.
See this image and copyright information in PMC

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