Gardner-Diamond syndrome: Difficulties in the management of patients with unexplained medical symptoms.

The case of an adolescent girl who presented with unexplained bruising is reported. Subsequent investigations failed to elucidate an organic etiology. The diagnosis of Gardner-Diamond syndrome - a syndrome of predictable bruising preceded by pain and warmth at the bruise site, often associated with physical or psychosocial stress - was made. In the present report, the authors use their experience with this rare syndrome to highlight some important ethical and practical considerations with regard to investigation, treatment and communication in illnesses with unexplained medical symptoms.