Taskaynatan Mehmet Ali, Balaban Birol, Karlidere Tunay, Ozgul Ahmet, Tan Arif Kenan, Kalyon Tunc Alp
Department of Physical Medicine and Rehabilitation, Gulhane Military Medical Academy, 06018, Etlik-Ankara, Turkey.
Clin Rheumatol. 2005 Sep;24(5):521-6. doi: 10.1007/s10067-005-1082-0. Epub 2005 Jul 12.
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.
反射性交感神经营养不良（RSD）对于存在非典型手部姿势和非典型水肿的患者可能是误诊，或者至少描述不够准确。7例先前诊断为RSD的患者因临床表现与潜在病理不符且病程怪异而接受了进一步调查。4例患者有握拳表现，3例有做作性水肿。这7例患者均接受了心理检查，并全部进行了明尼苏达多相人格调查表（MMPI）测试。其中2例根据《精神疾病诊断与统计手册》第四版（DSM-IV）未发现心理障碍。1例患者无法配合MMPI测试。诊断出2例患有焦虑症，1例患有抑郁症，1例患有转换障碍。我们认为这些患者改善自身状况的积极性不足，而且这类患者的期望可能会因环境不同而有所差异。
