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The Unexpected Hand Patient.

Andrew M Swiergosz1, Morton L Kasdan1, Bradon J Wilhelmi1

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Summary
This summary is machine-generated.

Physicians should consider malingering when subjective pain symptoms lack objective findings and secondary gain is suspected. A review of 21 cases supports this diagnostic consideration.

Keywords:
complex regional pain syndrome (CRPS)malingeringreflex sympathetic dystrophy (RSD)

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Area of Science:

  • Pain Medicine
  • Medical Diagnosis
  • Forensic Psychology

Background:

  • Physicians must recognize patients seeking diagnosis for secondary gain.
  • Malingering is suspected when subjective symptoms lack objective support and secondary gain is present.

Purpose of the Study:

  • To evaluate the diagnostic criteria for malingering in patients with suspected reflex sympathetic dystrophy (chronic regional pain syndrome).
  • To highlight the importance of identifying malingering in clinical practice.

Main Methods:

  • Retrospective chart review of 21 patients diagnosed with reflex sympathetic dystrophy (chronic regional pain syndrome).
  • Evaluation focused on nonanatomic findings and discrepancies between subjective symptoms and objective evidence.

Main Results:

  • Patients in this series were identified as malingering due to inconsistencies between reported symptoms and objective medical findings.
  • Discrepancies between subjective complaints and objective findings are key indicators of malingering.

Conclusions:

  • Diagnosis of malingering requires comprehensive assessment including history, physical exam, and diagnostic studies.
  • Thorough evaluation of all medical records is crucial for accurate malingering diagnosis.