[Complex regional pain syndrome type II or psychogenic painful finger contracture?].
The case is described of a 45-year-old man with fixed contracture of the proximal interphalangeal joints (digits III-IV) after a stab wound injury in the forearm with subsequent compartment syndrome and partial ulnar injury. Despite neurographic recovery there was permanent contracture during rehabilitation, which was classified as psychogenic. Differential diagnostic aspects of this assumption will be discussed on the basis of clinical criteria as well as 3-phase skeleton scintigraphy and MRT for differentiation between complex regional pain syndrome (CRPS) type II and other posttraumatic changes. Readers are encouraged to make their own diagnosis on the basis of the clinical findings and to discuss the case online (http://www.blogs.springer.com/derschmerz).
Abteilung Schmerztherapie, BG Universitätsklinikum Bergmannsheil, Ruhr-Universität Bochum, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Deutschland. christoph.maier@rub.de
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D000062:Accidents, Occupational; D003161:Compartment Syndromes / Q000150:complications; D020918:Complex Regional Pain Syndromes / Q000175:diagnosis* / Q000523:psychology; D003286:Contracture / Q000175:diagnosis* / Q000523:psychology; D003291:Conversion Disorder / Q000175:diagnosis* / Q000523:psychology; D003937:Diagnosis, Differential; D005384:Finger Joint; D005543:Forearm Injuries / Q000150:complications; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008306:Malingering / Q000175:diagnosis / Q000523:psychology; D008875:Middle Aged; D009460:Neurologic Examination; D011877:Radionuclide Imaging; D014459:Ulnar Nerve / Q000293:injuries; D014951:Wounds, Stab / Q000150:complications