Complex Regional Pain Syndrome and Factitious Disorders-Case: Complex Regional Pain Syndrome and Factitious Disorders

Case: Complex Regional Pain Syndrome and Factitious Disorders

Pdf Summary

A 63-year-old male presents with a gradual inability to open his right hand, following a previous neck surgery. On examination, there are no physical findings to indicate any abnormalities. The differential diagnosis includes clenched fist and complex regional pain syndrome (CRPS). Clenched fist is characterized by a minor inciting event, a clenched fist, macerated and foul-smelling palm, paradoxical stiffness, and swelling. CRPS presents with similar symptoms but lacks the clenched fist and has limitations in range of motion. Additional tools for evaluation include examination under anesthesia and psychological testing. Imaging studies such as x-rays and electromyogram/nerve conduction velocity studies may also be considered. Treatment for clenched fist includes splinting, stretching, hand therapy, and unclenching of the hand under general anesthesia if necessary. Psychological support and consultation are also important. It is essential to recognize clenched fist to prevent unnecessary surgical procedures.

Keywords

63-year-old male

inability to open hand

neck surgery

physical findings

clenched fist

complex regional pain syndrome

minor inciting event

paradoxical stiffness

swelling

range of motion