Some patients diagnosed with reflex sympathetic dystrophy (RSD) may have a factitious disorder. The recognition of a factitious disorder often depends on clinical expertise and careful observation of the patient.

Clinical features:

(1) atypical hand posture (clenching, other) and/or atypical edema of the upper extremity

(2) variable impaired active motion

(3) psychological disorder (anxiety, stress, depression, conversion disorder)

(4) failure to meet the criteria for RSD or to correspond to normal anatomy

(5) no underlying disease process that can explain findings


Edema may be caused by prolonged application of a tourniquet (Secretan Syndrome), by self-injections or by other self-inflicted interventions.


The motivation for the behavior is often unconscious although there may be some sort of reward (real or imagined).


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