Arthritis as a manifestation of self-mutilation in childhood.
Traumatic arthritis resulting from self-aggression is rarely encountered in children. Differentiation from child abuse and common causes of childhood arthritis is difficult and rests upon a high level of suspicion. We describe a 10-year-old girl with hand deformities associated with joint pain and swelling managed as juvenile rheumatoid arthritis for 3 years. Reevaluation revealed both physical and radiographic evidence of recurrent trauma. Psychiatric assessment confirmed the diagnosis of autoaggression leading to self-mutilation and psychosocial rehabilitation was essential in successful management.
Goldenstein-Schainberg
C
C
Department of Internal Medicine, University of São Paulo School of Medicine, Brazil.
Chu
L Y
LY
Pereira
R M
RM
Cossermelli
W
W
Szer
I S
IS
D001168:Arthritis / Q000000981:diagnostic imaging / Q000209:etiology*; D002648:Child; D002746:Chlorpromazine / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D006225:Hand / Q000000981:diagnostic imaging; D006801:Humans; D011613:Psychotherapy; D011859:Radiography; D012640:Seizures / Q000139:chemically induced; D012652:Self Mutilation / Q000150:complications* / Q000628:therapy
D002746:Chlorpromazine