Clinical Features: A patient presented to the RMIT University Chiropractic Teaching Clinic complaining of considerable back and lower limb pain and filled out pain drawings as part of their assessment.
Interventions and Outcomes: The drawings were scored as being psychosocial in origin using the Kirkaldy-Willis and Ransford methods of pain drawing assessment. During a thorough history obtained by the first author, then a final year student, the patient gave responses which caused the author to suspect the complaint was psychogenic in origin. Subsequently the patient was found to be suffering from a syrinx within the thoracic spinal cord as well as external spinal cord compression attributed to an arachnoid cyst.
Conclusion: This case report highlights problems with pain drawings determining pain of psychological and organic origin. Clinicians need to be discerning about the tools they use to diagnose psychological pain, the authors therefore recommend use of both pain drawings and physical tests prior to diagnosing pain of psychological origin.
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