Neuropathic Pain Syndrome Displayed by Malingerers

Ochoa, José L.; Verdugo, Renato J.

doi:10.1176/jnp.2010.22.3.278

Cited by 20 publications

(8 citation statements)

References 64 publications

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“…3,30 CRPS type II, which presents with an identifiable nerve lesion, may show a decrease in nerve conduction velocity and increased sensorimotor latency on electromyography. 31 Other diagnostic tools for CRPS include bone densitometry, infrared thermography, sweat testing, sympathetic blocks, bedside clinical examination methods, and targeted questionnaires. 1,28,32 MRI has been largely excluded in the CRPS literature because it has been shown to have lower sensitivity and specificity than a three-phase bone scan for CRPS.…”

Section: Discussionmentioning

confidence: 99%

Glomus Tumor of the Lower Extremity Previously Misdiagnosed as Complex Regional Pain Syndrome in Close Proximity to a Myxofibrosarcoma: A Case Report

Nazemi¹,

Grossi²,

Tavernier³

et al. 2022

JAAOS Glob Res Rev

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Complex regional pain syndrome (CRPS) is a potentially devastating condition that can result in severe psychological and social morbidity. It is a diagnosis of exclusion, and other pathologic entities must be ruled out first. Glomus tumors are exquisitely painful benign vascular tumors that are most common in the hand and are rarely found in the lower extremity. Here, we present a case of a patient who developed a focus of severe anterior knee pain and tenderness a few months after a car accident that had been misdiagnosed as CRPS for 15 years. She coincidentally developed a sarcoma of her ipsilateral leg distal to this site. Magnetic resonance imaging of the sarcoma included the area of knee pain where, interestingly, it identified a separate small soft-tissue mass. A glomus tumor was diagnosed histologically in a needle biopsy specimen from this mass, which was resected along with the sarcoma. For the first time in 15 years, despite the additional sarcoma surgery, she reported relief of her pain and complete resolution of her “CRPS.”

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Section: Discussionmentioning

confidence: 99%

Glomus Tumor of the Lower Extremity Previously Misdiagnosed as Complex Regional Pain Syndrome in Close Proximity to a Myxofibrosarcoma: A Case Report

Nazemi¹,

Grossi²,

Tavernier³

et al. 2022

JAAOS Glob Res Rev

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“…In a study of 237 CRPS patients, surveillance found that 16 of them (about 7%) were malingering [80].…”

Section: Discussionmentioning

confidence: 99%

The Budapest criteria for complex regional pain syndrome: The diagnostic challenge

Pergolizzi¹,

LeQuang²,

Nalamachu³

et al. 2018

anesthesiology

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Chronic regional pain syndrome (CRPS) is a neuropathic pain syndrome that involves both peripheral and central sensitization. Described in the literature as early as 1872, CRPS has been described using different names and different symptoms over the years. Since many neuropathic pain syndromes are rare, complex, and exhibit overlapping signs and symptoms, diagnosing CRPS has been challenging. Recently the Orlando Criteria in 1993, the subsequent Budapest Criteria in 2003 have attempted to provide a more helpful and robust diagnostic framework. However, the multiplicity of signs and symptoms and allowable variations have resulted in a diagnostic template that accommodates what may actually be a wide variety of conditions and obscures a better understanding of CRPS. The Budapest Criteria make CRPS ultimately a diagnosis of exclusion, leaving clinicians with patients who may be CRPS Type I, CRPS Type II or the new CRPS-NOS. CRPS can be challenging to treat and many treatments are ineffective, possibly owing to the fact that the syndrome is currently defined in such a diffuse way. The current diagnostic criteria of CRPS have even called the entire syndrome into question. There is an urgent need to better define and describe CRPS so that it can be appropriately diagnosed and its mechanisms elucidated. That step will lead to better treatment.

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“…Personal injury insurers require a means to assess the physical and psychological status of their insured, as occurrences of unconscious symptom exaggeration (Dersh, Polatin, Leeman and Gatchel, 2004;Howard, Kishino, Johnston, Worzer and Gatchel, 2010), frank malingering (Greve, Ord, Bianchini and Curtis, 2007;Ochoa and Verdugo, 2010), and over-provision of services (Eisendrath, Rand and Feldman, 1996;Green 2011) exist in personal injury cases. Without independent medical examinations (IMEs), insurers' costs would escalate to a level that would potentially make the provision of coverage unrealistic.…”

Section: Introductionmentioning

confidence: 99%

Erratum to: Cherry-Picking Records in Independent Medical Examinations: Strategies for Intervention to Mitigate a Legal and Ethical Imbroglio

Schatman

Thoman²

2014

Psychol. Inj. and Law

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Independent medical examinations (IMEs) theoretically construe a means of "independently" assessing a claimant's physical and psychological status, as well as to determine whether treatment that has been and will potentially be provided is reasonable and necessary. IMEs may be undertaken both for the plaintiff and defense or related adversaries. In the present case, we focus on IMEs that are requested by insurers. One can query the degree to which IMEs are actually "independent." It has been posited that one of the ways in which claims managers contribute to potential bias against claimants is through a process of selectively providing examiners with medical records, which has been described as "cherry-picking." Despite the existence of rules and laws that are designed to prevent cherry-picking, the practice still occurs. This analysis discusses the legal as well as ethical implications of cherry-picking and its potential to cause or exacerbate psychological injury that a claimant may experience. The authors propose that psychologists as well as attorneys can advocate for their vulnerable patients/clients in cases of cherry-picking. A recent case study from the clinical practice of the first author in which he so acted is provided. We conclude with a discussion of the ethical implications of the psychologist's intervention.

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Neuropathic Pain Syndrome Displayed by Malingerers

Cited by 20 publications

References 64 publications

Glomus Tumor of the Lower Extremity Previously Misdiagnosed as Complex Regional Pain Syndrome in Close Proximity to a Myxofibrosarcoma: A Case Report

Glomus Tumor of the Lower Extremity Previously Misdiagnosed as Complex Regional Pain Syndrome in Close Proximity to a Myxofibrosarcoma: A Case Report

The Budapest criteria for complex regional pain syndrome: The diagnostic challenge

Erratum to: Cherry-Picking Records in Independent Medical Examinations: Strategies for Intervention to Mitigate a Legal and Ethical Imbroglio

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