Geraci Giuseppe, Di Martino Alberto, Casadei Cinzia, Brunello Matteo, Stefanini Niccolò, Faldini Cesare
IRRCS - Istituto Ortopedico Rizzoli; 1st Orthopedic Department, Bologna, Italy.
Department of Biomedical and Neurimotor Sciences - DIBINEM - University of Bologna, Bologna, Italy.
Int Orthop. 2025 Feb;49(2):357-364. doi: 10.1007/s00264-024-06387-y. Epub 2024 Dec 9.
Psychiatric disorders significantly impact orthopaedic practice, often manifesting in ways that can complicate diagnosis and treatment. This narrative review explores psychiatric conditions that mimic musculoskeletal disorders, including Conversion Disorder, Factitious Disorder, Somatic Symptom Disorder, and Malingering. These disorders present a range of challenges, from interfering with accurate diagnosis to contributing to suboptimal clinical outcomes and increased healthcare costs. Is fundamental the role of orthopaedic surgeons in recognizing these conditions, which can present as genuine musculoskeletal symptoms but have underlying psychiatric origins. It emphasizes the need for heightened awareness and proper training to avoid misdiagnosis and ensure timely, appropriate treatment. By examining current literature, the review provides a comprehensive overview of each disorder, detailing their clinical presentations, diagnostic criteria, and treatment strategies. The aim is to enhance orthopedic practitioners' ability to identify and manage these complex cases effectively, improving patient care and reducing the risk of unnecessary interventions.
精神疾病对骨科实践有重大影响，其表现方式常常会使诊断和治疗复杂化。本篇叙述性综述探讨了模仿肌肉骨骼疾病的精神状况，包括转换障碍、做作性障碍、躯体症状障碍和诈病。这些疾病带来了一系列挑战，从干扰准确诊断到导致临床结果不佳和医疗成本增加。骨科医生在识别这些状况方面的作用至关重要，这些状况可能表现为真正的肌肉骨骼症状，但有着潜在的精神根源。它强调需要提高认识并进行适当培训，以避免误诊并确保及时、恰当的治疗。通过审视当前文献，该综述全面概述了每种疾病，详细介绍了它们的临床表现、诊断标准和治疗策略。目的是提高骨科从业者有效识别和管理这些复杂病例的能力，改善患者护理并降低不必要干预的风险。
