Munchausen syndrome: A differential diagnostic trap for hand surgeons

A 24-year-old woman was referred with an extremely painful, stiff, swollen, and hypersensitive right upper extremity. She had history of four previous operations on the same extremity. The primary diagnosis was complex regional pain syndrome. During the next few days her symptoms worsened and she developed fever. It was discovered that the patient was preheating more than one thermometer and was intentionally injuring herself. The final diagnosis was Munchausen syndrome.