Factitious lymphoedema as a psychiatric condition mimicking reflex sympathetic dystrophy: a case report

Nnamdi Nwaejike¹ , HAP Archbold² and Darrin S Wilson²

¹Department of Vascular and Endovascular Surgery, Barts and The London NHS Trust, The Royal London Hospital, London, E1 1BB, UK

²Department of Fractures and Orthopaedics, The Royal Victoria Hospital, Grosvenor Road, Belfast, BT12 BA, UK

author email corresponding author email

Journal of Medical Case Reports 2008, 2:216doi:10.1186/1752-1947-2-216


Published:	24 June 2008

Abstract

Introduction

Reflex sympathetic dystrophy can result in severe disability with only one in five patients able to fully resume prior activities. Therefore, it is important to diagnose this condition early and begin appropriate treatment. Factitious lymphoedema can mimic reflex sympathetic dystrophy and is caused by self-inflicted tourniquets, blows to the arm or repeated skin irritation. Patients with factitious lymphoedema have an underlying psychiatric disorder but usually present to emergency or orthopaedics departments. Factitious lymphoedema can then be misdiagnosed as reflex sympathetic dystrophy. The treatment for factitious lymphoedema is dealing with the underlying psychiatric condition.

Case presentation

We share our experience of treating a 33-year-old man, who presented with factitious lymphoedema, initially diagnosed as reflex sympathetic dystrophy.

Conclusion

Awareness of this very similar differential diagnosis allows early appropriate treatment to be administered.