Overlooked physical diagnoses in chronic pain patients involved in litigation

Abstract

This study followed the course of 60 chronic pain patients, from referral to a pain diagnostic center through the formulation of complete discharge diagnoses. The most common referral "diagnoses" were really descriptions or vague explanations, such as "chronic pain," "psychogenic pain," "cervical strain," or "lumbar strain." The most commonly missed diagnoses were 1) myofascial disease, 2) facet disease, 3) peripheral nerve entrapment, 4) radiculopathy, and 5) thoracic outlet syndrome. Seventy percent of the laboratory studies ordered by the clinic had significant abnormalities. The authors determined that the overall rate of inaccurate or incomplete diagnosis at referral was 66.7%.