Complex Regional Pain Syndrome (CRPS): Difference between revisions
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== Diagnostic Tests/Lab Tests/Lab Values == | == Diagnostic Tests/Lab Tests/Lab Values == | ||
Diagnosis of CRPS is based solely on examination and patient history.<ref name="Patho Book" /> A triple-phase bone scan is the best method to rule out type I CPRS.<ref name="Cappello">Cappello Z, Kasdan M, Louis D. Meta-analysis of imaging techniques for the diagnosis of complex regional pain syndrome type I. JHS 2012;37A:288-296.</ref> According to Cappello, the triple-phase bone scan has the best sensitivity, NPV, and PPV compared to MRI and plain film radiographs.<ref name="Cappello" /> Radiographic examinations, laser Doppler flowmetry, and thermographic studies may be utilized to assess the secondary issues and symptoms of CRPS.<ref name="Patho Book" /><br> | |||
== Etiology/Causes == | == Etiology/Causes == | ||
Revision as of 21:24, 28 March 2012
Original Editors - Katelyn Koeninger & Kristen Storrie from Bellarmine University's Pathophysiology of Complex Patient Problems project.
Lead Editors - Your name will be added here if you are a lead editor on this page. Read more.
Definition/Description[edit | edit source]
Complex Regional Pain Syndrome (CRPS) is also known as reflex sympathetic dystrophy, causalgia, Sudeck's atrophy, algoneurodystrophy, among other names. It is a disease causing severe pain, disproportional to the expected amount of pain from a stimulus.[1] It is typically confined in one limb, but may spread to other limbs or even to the entire body. A person with CRPS will experience sensory, motor, autonomic, and skin/bone changes.[2]
There are two types of CRPS. CRPS type I occurs after any type of trauma. CRPS type II may also occur after trauma, but has neuronal involvement. CRPS most commonly occurs after surgery (including arthroscopies), upper and lower motor neuron injuries, traumatic brain injury, cerebrovascular accident, central nervous system lesion, neuropathies, or nerve entrapments.[1]
Prevalence[edit | edit source]
CPRS affects approximately 26 out of every 100,000 people. It is more common in females than males, with a ratio of 3.5:1.[2] CRPS can affect people of all ages, including children as young as 3 years old and adults as old as 75 years old, but typically is most prevalent beginning in the mid-thirties. CRPS type I occurs after 5% of all traumatic injuries.[1] 91% of all CRPS cases occur after surgery.[3]
Characteristics/Clinical Presentation[edit | edit source]
Signs and Symptoms of CRPS:
• pain, not present in 7%[1] [2]
• swelling[1][2]
• Tremor[1]
• trouble initiating movements[1]
• muscle spasms[1]
• muscle atrophy[1]
• temperature changes[1][2]
• color changes (red, blue)[1]
• thick, brittle, or rigid nails[1]
• weakness[1][2]
• thin, shiny, clammy skin[2]
• stiffness or decreased joint motion[2]
• painful or decreased sensation on skin (some patients report intolerance to air moving over skin)[2]
• strange, disfigured, or dislocated feelings in limbs[2]
Associated Co-morbidities[edit | edit source]
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Medications[edit | edit source]
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Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
Diagnosis of CRPS is based solely on examination and patient history.[1] A triple-phase bone scan is the best method to rule out type I CPRS.[4] According to Cappello, the triple-phase bone scan has the best sensitivity, NPV, and PPV compared to MRI and plain film radiographs.[4] Radiographic examinations, laser Doppler flowmetry, and thermographic studies may be utilized to assess the secondary issues and symptoms of CRPS.[1]
Etiology/Causes[edit | edit source]
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Systemic Involvement[edit | edit source]
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Medical Management (current best evidence)[edit | edit source]
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Physical Therapy Management (current best evidence)[edit | edit source]
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Alternative/Holistic Management (current best evidence)[edit | edit source]
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Differential Diagnosis[edit | edit source]
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Case Reports/ Case Studies[edit | edit source]
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Resources
[edit | edit source]
• Reflex Sympathetic Dystrophy Syndrome Association
• American Chronic Pain Association
• National Institute of Neurological Disorders and Stroke
Recent Related Research (from Pubmed)[edit | edit source]
see tutorial on Adding PubMed Feed
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References[edit | edit source]
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- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 Goodman C, Fuller K. Pathology: Implications for the Physical Therapist. Saint Louis: Saunders Elsevier, 2009.
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 2.9 Goebel A. Complex regional pain syndrome in adults. Rheumatology. 2011;50;288-6.
- ↑ Turner-Stokes L, Goebel A. Complex regional pain syndrome in adults: concise guidance. Clinical Med 2011; 11(6):596-600.
- ↑ 4.0 4.1 Cappello Z, Kasdan M, Louis D. Meta-analysis of imaging techniques for the diagnosis of complex regional pain syndrome type I. JHS 2012;37A:288-296.
- ↑ CNN. CNN Report on Reflex Sympathetic Dystrophy. Available from: http://www.youtube.com/watch?v=jaTlI6bfF64 [last accessed 3/28/12]
