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

Abstract 

The purpose of this case-control study was to assess the frequency of the inappropriate diagnosis of reflex sympathetic dystrophy (RSD) in patients who presented with dysfunctional postures of the upper extremity (n = 43). This group of patients with a dysfunctional posture was compared with a randomly selected control group of patients who presented with pain but no dysfunctional posture (n = 88). The patients underwent radiographic evaluation after review of previous medical records and history and physical examination. Patients with dysfunctional postures had a significantly higher frequency (63%) of a previous inappropriate diagnosis of RSD compared with the control group (6%). None of the patients in either group had objective findings consistent with a diagnosis of RSD. Patients presenting with dysfunctional postures of the upper extremity may be misdiagnosed as having RSD and rarely meet the criteria for this diagnosis. (J Hand Surg 2000;25A:1152-1156. Copyright © 2000 by the American Society for Surgery of the Hand.)

Keywords:  Dysfunctional postures, reflex sympathetic dystrophy, factitious disorder, malingering, nocebo effect