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Factitious disorders of the upper extremity
Michael V Birman1, Donald H Lee
1Department of Orthopaedic Surgery, Columbia University, New York, NY, USA.
The Journal of the American Academy of Orthopaedic Surgeons
|February 4, 2012
Summary
Recognizing factitious disorders of the upper extremity is crucial for physicians. Early identification of symptoms like lymphedema and self-mutilation prevents unnecessary surgeries and protects patients and doctors.
Area of Science:
- Orthopedics
- Psychiatry
Background:
- Factitious disorders of the upper extremity present with diverse symptoms.
- Recognizing self-inflicted symptoms is critical for accurate diagnosis and management.
Purpose of the Study:
- To highlight the varied presentations of factitious disorders in the upper extremity.
- To emphasize the importance of identifying warning signs during patient evaluation.
- To provide management recommendations for these complex cases.
Main Methods:
- Review of common manifestations of factitious disorders of the upper extremity.
- Discussion of diagnostic clues from patient history and physical examination.
- Outline of recommended treatment and documentation strategies.
Main Results:
- Factitious disorders manifest predictably as lymphedema, Secretan syndrome, ulcerations, clenched fist, emphysema, pachydermodactyly, nail deformities, and self-mutilation.
- Early recognition of these patterns is key to appropriate patient care.
- Multidisciplinary team involvement and consistent documentation are vital.
Conclusions:
- Physicians must be vigilant for signs of factitious disorders in upper extremity presentations.
- A unified therapeutic approach and meticulous documentation are essential.
- Avoiding unnecessary surgical interventions requires insight and patience.
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