Reflex sympathetic dystrophy: Misdiagnosis in patients with dysfunctional postures of the upper extremity

Stutts, John T.; Kasdan, Morton L.; Hickey, Scott E.; Bruner, Andrew

doi:10.1053/jhsu.2000.17867

Cited by 8 publications

(2 citation statements)

References 20 publications

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“…40 The value of such an approach is disputed though, 41 and other neurologists consider the condition to be overtly psychologically mediated, 42–45 as do most surgeons. 46,47 Nevertheless, there is a gray line in dystonia/psychogenic hand–complex regional pain syndrome 48 in which patients may be allocated erroneously to one or the other, 45 and we have explored that “frontier.” We operated on five patients with dystonia–complex regional pain syndrome: three of them could not make a fist and were included in this study. One of them was cured [See Video 4 (online), which shows the immediate response to surgery in a dystonia–complex regional pain syndrome hand patient (patient 35)]; another had less pain and some range-of-motion improvement; and the third patient’s condition worsened, as reported.…”

Section: Discussionmentioning

confidence: 99%

“…40 The value of such an approach is disputed though, 41 and other neurologists consider the condition to be overtly psychologically mediated, [42][43][44][45] as do most surgeons. 46,47 Nevertheless, there is a gray line in dystonia/psychogenic hand-complex regional pain syndrome 48 in which patients may be allocated erroneously to one or the other, 45 and we have explored that "frontier." We operated on five patients with dystonia-complex regional pain syndrome: three of them could not make a fist and were included in this study.…”

Section: Plastic and Reconstructive Surgery • July 2022mentioning

confidence: 99%

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Outcomes of Carpal Tunnel Release in Complex Regional Pain Syndrome/Reflex Sympathetic Dystrophy/Sudeck Disease Patients

Piñal

2022

Plastic &Amp; Reconstructive Surgery

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All great truths begin as blasphemies.-George Bernard Shaw W e have observed a group of patients who do not display the typical carpal tunnel syndrome signs and symptoms. 1,2 Their main complaints are pain and allodynia, often not limited to the median nerve distribution, worsening at night, and above all, inability to make a full fist (Fig. 1, above and center). Despite the different presentation from the typical carpal tunnel syndrome patient, they respond equally well to carpal tunnel release (Fig. 1 , below).Apparently unrelated to the description above, or to a problem in the carpal canal, is the condition known as complex regional pain syndrome of the upper limb (also known as reflex sympathetic dystrophy, Sudeck disease, or algodystrophy). Its clinical picture is characterized by trophic and vasomotor changes and, above all, pain out of proportion, which may be constant, present at rest or with the slightest movement, and with varying severity of allodynia and hyperalgesia. Disturbed sleep is the norm. The hand appearance changes over time: initially red, warm, and swollen, it later becomes whiter, drier, cooler, and stiffer. [3][4][5][6][7][8][9][10] Despite the abundant literature and research, complex regional pain syndrome has an

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Section: Discussionmentioning

confidence: 99%

Section: Plastic and Reconstructive Surgery • July 2022mentioning

confidence: 99%

Outcomes of Carpal Tunnel Release in Complex Regional Pain Syndrome/Reflex Sympathetic Dystrophy/Sudeck Disease Patients

Piñal

2022

Plastic &Amp; Reconstructive Surgery

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Factitious disorders encountered in patients with the diagnosis of reflex sympathetic dystrophy

et al. 2005

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Reflex sympathetic dystrophy (RSD) may be a misdiagnosis or at least not descriptive enough in patients with atypical hand posture and atypical edema. Seven patients with the previous diagnosis of RSD were investigated further because of inconsistent clinical picture with the underlying pathology and bizarre course of the disease. Four patients had clenched fist and three had factitious edema. These seven patients underwent psychological examination, and MMPI was applied to all. In two of these no psychological disorder was obtained according to DSM-IV. One patient could not adapt to MMPI. In two anxiety disorders, in one depression, and in one patient conversion disorder was diagnosed. We suggest that these patients are not motivated enough to improve their conditions and expectations of such patients may show some differences depending on the environment.

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Factitious Disorders

Louis¹,

Kasdan²

2011

Green's Operative Hand Surgery

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Reflex sympathetic dystrophy: Misdiagnosis in patients with dysfunctional postures of the upper extremity

Cited by 8 publications

References 20 publications

Outcomes of Carpal Tunnel Release in Complex Regional Pain Syndrome/Reflex Sympathetic Dystrophy/Sudeck Disease Patients

Outcomes of Carpal Tunnel Release in Complex Regional Pain Syndrome/Reflex Sympathetic Dystrophy/Sudeck Disease Patients

Factitious disorders encountered in patients with the diagnosis of reflex sympathetic dystrophy

Factitious Disorders

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