Psychosomatics 1993; 34:494-501
Copyright © 1993 by Academy of Psychosomatic Medicine
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ORIGINAL RESEARCH REPORTS |
Overlooked physical diagnoses in chronic pain patients involved in litigation
NH Hendler and JG Kozikowski
Mensana Clinic, Stevenson, MD 21153.
This study followed the course of 60 chronic pain patients, from referral
to a pain diagnostic center through the formulation of complete discharge
diagnoses. The most common referral "diagnoses" were really descriptions or
vague explanations, such as "chronic pain," "psychogenic pain," "cervical
strain," or "lumbar strain." The most commonly missed diagnoses were 1)
myofascial disease, 2) facet disease, 3) peripheral nerve entrapment, 4)
radiculopathy, and 5) thoracic outlet syndrome. Seventy percent of the
laboratory studies ordered by the clinic had significant abnormalities. The
authors determined that the overall rate of inaccurate or incomplete
diagnosis at referral was 66.7%.
