Complex Regional Pain Syndrome I (CRPS I): Prospective study and laboratory evaluation

Paola Sandroni, Phillip Anson Low, Teresa Ferrer, Tonette L. Opfer-Gehrking, Catherine L. Willner, Peter R. Wilson

Research output: Contribution to journalArticle

59 Citations (Scopus)

Abstract

Objective: To relate clinical features to autonomic laboratory indices used in the diagnosis of Complex Regional Pain Syndrome type I (CRPS I) (reflex sympathetic dystrophy) to generate improved diagnostic criteria. Description: CRPS I is a chronic pain syndrome, characterized by diffuse limb pain with allodynia and prominent vasomotor and sudomotor dysfunction. Methods: We conducted a prospective study on 102 patients referred for possible CRPS I. These patients completed a structured questionnaire and underwent neurologic examination, with special attention to the evaluation of clinical features of vasomotor, sudomotor, motor, and sensory, including pain, dysfunction. All patients were tested using a standard autonomic protocol that compared side-to-side skin temperature, resting sweat output, and quantitative sudomotor axon reflex test (QSART) measurements. Composite autonomic clinical (CRPS-Sx) and laboratory (CRPS-LAB) scores were defined. The clinical (subjective and objective) and the laboratory data were analyzed using Pearson's correlation analysis and Bonferroni's probability value to assess concordance and their value in correctly diagnosing CRPS I. Results: All cases occurred after limb injury. One-third of cases did not fulfill our criteria of CRPS I. Highly significant correlations (p < .001) were found among certain clusters of symptoms and signs that shared unifying pathophysiologies. CRPS-Sx correlated with CRPS-LAB (p = .035). The indices that correlated most reliably with clinical data and with each other were RSO, QSART, and skin temperature reductions. Conclusion: Clinical and autonomic laboratory probability scores correlate in an internally consistent manner. Both CRPS-Sx and CRPS-LAB are sensitive and reliable tools to formulate a correct diagnosis of CRPS I and can be combined to provide an improved set of diagnostic criteria for CRPS I.

Original languageEnglish (US)
Pages (from-to)282-289
Number of pages8
JournalClinical Journal of Pain
Volume14
Issue number4
DOIs
StatePublished - Dec 1998

Fingerprint

Complex Regional Pain Syndromes
Prospective Studies
Reflex Sympathetic Dystrophy
Skin Temperature
Axons
Reflex
Extremities
Pain
Sweat
Hyperalgesia
Neurologic Examination
Chronic Pain
Signs and Symptoms
Wounds and Injuries

Keywords

  • Autonomic
  • QSART
  • RSD
  • Sympathetic
  • Vasomotor

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Clinical Neurology

Cite this

Complex Regional Pain Syndrome I (CRPS I) : Prospective study and laboratory evaluation. / Sandroni, Paola; Low, Phillip Anson; Ferrer, Teresa; Opfer-Gehrking, Tonette L.; Willner, Catherine L.; Wilson, Peter R.

In: Clinical Journal of Pain, Vol. 14, No. 4, 12.1998, p. 282-289.

Research output: Contribution to journalArticle

Sandroni, Paola ; Low, Phillip Anson ; Ferrer, Teresa ; Opfer-Gehrking, Tonette L. ; Willner, Catherine L. ; Wilson, Peter R. / Complex Regional Pain Syndrome I (CRPS I) : Prospective study and laboratory evaluation. In: Clinical Journal of Pain. 1998 ; Vol. 14, No. 4. pp. 282-289.
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