Arthritis as a manifestation of self-mutilation in childhood.

Goldenstein-Schainberg, C; Chu, L Y; Pereira, R M; Cossermelli, W; Szer, I S · J Rheumatol · 1992

case_report · Level V

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Abstract

Traumatic arthritis resulting from self-aggression is rarely encountered in children. Differentiation from child abuse and common causes of childhood arthritis is difficult and rests upon a high level of suspicion. We describe a 10-year-old girl with hand deformities associated with joint pain and swelling managed as juvenile rheumatoid arthritis for 3 years. Reevaluation revealed both physical and radiographic evidence of recurrent trauma. Psychiatric assessment confirmed the diagnosis of autoaggression leading to self-mutilation and psychosocial rehabilitation was essential in successful management.

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