Is there a correlation between symptoms and bone scintigraphic findings in patients with complex regional pain syndrome?

AlSharif, Abedallatif; Akel, Alaa Y.; Sheikh-Ali, Rasha F.; Juweid, Malik E.; Hawamdeh, Ziad M.; Ajlouni, Jihad; Abdulsahib, Ameer S.; Hadidi, Fadi; ElHadidy, Shaher T.

doi:10.1007/s12149-012-0623-2

Cited by 8 publications

(4 citation statements)

References 21 publications

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“…Moreover, 3 prospective studies have been also published [26,27,30] confirming the usefulness of TBPS as additional tool in doubtful cases [30] and when the duration of the pathology is shorter than 3 [26] or 5 months [27]. Two other retrospective studies [36,37] using the Budapest criteria were also recently published. Moon et al [36], found a low utility of TBPS for diagnosis of CRPS and AlSharif et al [37] found a positive scintigraphy in patients with vasomotor symptoms, motor and/or trophic changes, with a duration of less than 3 months.…”

Section: Discussionmentioning

confidence: 94%

“…Two other retrospective studies [36,37] using the Budapest criteria were also recently published. Moon et al [36], found a low utility of TBPS for diagnosis of CRPS and AlSharif et al [37] found a positive scintigraphy in patients with vasomotor symptoms, motor and/or trophic changes, with a duration of less than 3 months. In our study, TBPS was also particularly helpful when it was performed in the first 6 months.…”

Section: Discussionmentioning

confidence: 99%

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Diagnosis of partial complex regional pain syndrome type 1 of the hand: retrospective study of 16 cases and literature review

2013

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BackgroundThe partial form of the complex regional pain syndrome of the hand type 1 (CRPS 1), involving only 1 to 3 fingers, is a rare condition first described in 1972. The aim of the study is to define more precisely the diagnosis workup and the prognosis of this clinical entity.MethodsRetrospective study of CRPS1 partial form observed during five years in a rehabilitation ward. Application of The Budapest criteria, evaluation of radiological exams, therapeutic results and vocational outcomes. Comparison with cases from literature review.Results132 patients were hospitalized with the diagnosis of CRPS type 1 of the hand. 16 partial forms were isolated: 11 men, 5 women with a mean age of 43 years. Among these patients, 14 (88%) met The Budapest criteria and the two remaining cases were diagnosed by using the three phase bone scintigraphy. Only moderate improvement was obtained in the majority of the patients. At the maximal time of follow-up (4 to 9 years), 50% of the patients hadn’t returned to work. From the literature review, 19 cases were eligible for clinical comparisons. The main differences between our series and the literature were: more men involved, later diagnosis and worst prognosis in term of return to work.ConclusionsThis is the largest series of consecutive partial form of CRPS. The Budapest criteria are sufficient for the diagnosis in 88% of cases. As in complete form of CRPS1 of the hand, three phase bone scintigraphy should only be used in doubtful cases in the first six months of the illness. Partial form of CRPS1 of the hand is rare and its prevalence remains unknown. Long term prognosis (4 to 9 years) is poor in our series, 50% of patients didn’t returned to work.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Diagnosis of partial complex regional pain syndrome type 1 of the hand: retrospective study of 16 cases and literature review

2013

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“…[40, 41, 46, 48, 49] Seven studies [30–32, 36–38] did not report on the diagnostic criteria used for the diagnosis of CRPS 1 and two studies [33, 39] used other clinical criteria In total 13 studies were included in the analysis of the influence of patient characteristics on the proportion of positive bone scans. [29, 34, 42, 43, 45, 47, 50–56] We included five studies using the IASP criteria [34, 52–55] and one study using the Budapest criteria [51] that reported results on the sensitivity of BS in patients meeting the clinical diagnostic criteria for the diagnosis of CRPS 1. The extracted information for each study used for the diagnostic meta-analysis is provided in S4 Table.…”

Section: Resultsmentioning

confidence: 99%

Usefulness of bone scintigraphy for the diagnosis of Complex Regional Pain Syndrome 1: A systematic review and Bayesian meta-analysis

et al. 2017

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BackgroundSince 2007, the Budapest criteria are recommended for the diagnosis of Complex Regional Pain Syndrome (CRPS) 1. The usefulness of bone scintigraphy (BS, index test) for the diagnosis of CRPS 1 remains controversial. Imperfect reference tests (RT) result in underestimation of the diagnostic accuracy of BS. Further, biased results can occur when a dependency between the RT and BS exists.The objective was to assess the impact of different RTs, specifically the Budapest criteria, and the assumed imperfect nature of the RT on the diagnostic accuracy of BS. Further, we analyzed the association between baseline characteristics and positive BS in patients with CRPS 1.MethodsSystematic literature review and Bayesian meta-analysis to assess the test accuracy of BS with and without accounting for the imperfect nature of the RT. We examined correlations (Spearman correlation coefficients / Wilcoxon tests) between baseline characteristics and the proportion of positive BS in patients with CRPS 1.ResultsThe pooled sensitivity was 0.804 (95% credible interval (CI) 0.225–1.0, 21 studies) and specificity 0.853 (95%CI 0.278–1.00). Sensitivity and specificity of BS increased when accounting for the imperfect nature of the RT. However, in studies using Budapest criteria as reference, the sensitivity decreased (0.551; 95% CI 0.046–1) and the specificity increased (0.935; 95% CI 0.306–1). Shorter disease duration and a higher proportion of males were associated with a higher proportion of positive BS (27 studies, disease duration <52 weeks Wilcoxon test p = 0.047, female proportion Spearman correlation −0.63, p = 0.009).ConclusionCompared to the accepted Budapest diagnostic criteria BS cannot be used to rule-in the diagnosis of CRPS 1. In patients with negative BS CRPS 1 is less likely the underlying illness. Studies using older or no diagnostic criteria should not be used to evaluate the diagnostic accuracy of BS in CRPS 1.

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“…Potentially useful tests include thermography (to document skin temperature asymmetry) and volumetry (to document the extent of edema). Triple-phase bone scan results may correspond with the clinical CRPS diagnosis to some degree, 7,250 but this test is neither definitive nor necessary for diagnosis. CRPS may occur with pain that is not responsive to pharmacologic sympathetic blockade, so diagnostic sympathetic blocks are unnecessary.…”

Section: Dimension 2: Common Features Including Epidemiology and Lifmentioning

confidence: 99%

AAPT Diagnostic Criteria for Peripheral Neuropathic Pain: Focal and Segmental Disorders

Freeman

Edwards

Baron

et al. 2019

The Journal of Pain

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Is there a correlation between symptoms and bone scintigraphic findings in patients with complex regional pain syndrome?

Abstract: The probability of positive bone scintigraphy increased significantly in patients with vasomotor symptoms and in patients with motor and/or trophic changes. This may contribute to the reported variability of the diagnostic performance of bone scintigraphy in CRPS patients.

Cited by 8 publications

References 21 publications

Diagnosis of partial complex regional pain syndrome type 1 of the hand: retrospective study of 16 cases and literature review

Diagnosis of partial complex regional pain syndrome type 1 of the hand: retrospective study of 16 cases and literature review

Usefulness of bone scintigraphy for the diagnosis of Complex Regional Pain Syndrome 1: A systematic review and Bayesian meta-analysis

AAPT Diagnostic Criteria for Peripheral Neuropathic Pain: Focal and Segmental Disorders

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