Reflex sympathetic dystrophy: changing concepts and taxonomy

Abstract

We present a revised taxonomic system for disorders previously called reflex sympathetic dystrophy (RSD) and causalgia. The system resulted from a special consensus conference that was convened on this topic and is based upon the patient's history, presenting symptoms, and findings at the time of diagnosis. The disorders are grouped under the umbrella term CRPS: complex regional pain syndrome. This overall term, CRPS, requires the presence of regional pain and sensory changes following a noxious event. Further, the pain is associated with findings such as abnormal skin color, temperature change, abnormal sudomotor activity, or edema. The combination of these findings exceeds their expected magnitude in response to known physical damage during and following the inciting event. Two types of CRPS have been recognized: type I, corresponds to RSD and occurs without a definable nerve lesion, and type II, formerly called causalgia refers to cases where a definable nerve lesion is present. The term sympathetically maintained pain (SMP) was also evaluated and considered to be a variable phenomenon associated with a variety of disorders, including CRPS types I and II. These revised categories have been included in the 2nd edition of the IASP Classification of Chronic Pain Syndromes.

Wherever is my arm? Impaired upper limb position accuracy in Complex Regional Pain Syndrome

“…Twenty participants aged between 18 and 65 years who met the International Association of the Study of Pain classification criteria for CRPS Type I and II [43] of one upper limb were drawn from a UK population. Additional inclusion criteria were that they could perform 90° shoulder abduction bilaterally, could verbally communicate and had no co-morbidity such as diabetic neuropathy that might influence performance.…”

Diagnostic Performance of Three-Phase Bone Scan for Complex Regional Pain Syndrome Type 1 with Optimally Modified Image Criteria

“…A diagnosis of CRPS-1 is usually based on clinical criteria, including symptoms and signs without an objective diagnostic test [2,3]. Since the International Association for the Study of Pain (IASP) coded the name and diagnostic criteria for the syndrome in 1994, there has been much effort to develop more accurate and valid diagnostic criteria for CRPS [4]. The most recent modification to the clinical diagnostic consensus criteria was proposed at an expert meeting held in Budapest in 2003.…”

Rare case of autonomic instability of the lower limb presenting as painless Complex Regional Pain Syndrome type I following hip surgery: two case reports

“…Pain out of proportion to the injury is an essential criterion for the diagnosis of Complex Regional Pain Syndrome (CRPS) type I [1]-[3]. We present two cases of CRPS like symptoms following hip surgery but with the complete absence of pain.…”