Type I complex regional pain syndrome: MRI may be misleading

Marsland, Daniel; Konyves, Arpad; Cooper, Robert C.; Suvarna, S K

doi:10.1016/j.injury.2007.09.012

Cited by 8 publications

(6 citation statements)

References 13 publications

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“…MRI may also be helpful to distinguish osteonecrosis from other bone disorders. 9 Another compelling condition was the coexistence of ON and inflammatory monoarthritis that caused a question whether they were related or not. In the literature it is known that in ON, acute synovitis episodes could develop but non-inflammatory properties are proposed.…”

Section: Discussionmentioning

confidence: 99%

A Condition Confused with Complex Regional Pain Syndrome in Hemiplegia: Simultaneous Occurance of Knee Osteonecrosis and Monoarthritis

Özcan¹,

Köseoğlu²,

Taşkin³

et al. 2018

J PMR Sci

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steonecrosis (ON) is a progressive disease that often causes subchondral collapse and disability at the affected joint. Pain and reduced range of motion are usually revealed in symptomatic patients. ON of the knee is divided into three categories: 1. Spontaneous ON of the knee, 2. Secondary ON and 3. Post-arthroscopic ON. Secondary ON is associated with systemic steroid therapy, systemic lupus erythematosus, smoking, haemoglobinopathies, dyslipidemia and alcohol abuse. A AB BS ST TR RA AC CT T Complex regional pain syndrome (CRPS) type 1 is a painful condition commonly seen in hemiplegia and affects negatively the rehabilitation process. We report a case of 42-year-old male with right sided hemiplegia who developed acute inflammatory monoarthritis at the right knee joint during the stroke rehabilitation program. The patient also had clinically silent knee osteonecrosis (ON) that noticed after the clinical and radiological examination period for the inflammatory monoarthritis. The cause of the monoarthritis was investigated but it remained indeterminate. The coexistence of these two conditions led to a diagnostic confusion with complex regional pain syndrome type 1 (CRPSt1). In this case report we aimed to stimulate further thought in the field of misdiagnosing CRPSt1. We also discussed whether ON and inflammatory monoarthritis were related or not. We highlighted the importance of distinguishing CRPS and ON especially in stroke patients. A high index of suspicion could avoid diagnostic delay.K Ke ey yw wo or rd ds s: : Osteonecrosis; complex regional pain syndrome; hemiplegia; arthritis; rehabilitation Ö ÖZ ZE ET T Kompleks bölgesel ağrı sendromu (KBAS) tip 1 hemiplejide yaygın olarak görülen ve rehabilitasyon sürecini olumsuz etkileyen ağrılı bir durumdur. Bu yazıda, 42 yaşında sağ hemipleji tanılı, inme rehabilitasyon programı sırasında sağ dizinde akut inflamatuar monoartrit gelişen bir erkek hasta sunuldu. İnflamatuar monoartrite yönelik yapılan klinik ve radyolojik incelemeler sırasında hastada klinik olarak sessiz seyreden bilateral diz osteonekrozu olduğu fark edildi. İnflamatuar monoartrite yol açan spesifik bir romatolojik hastalık tespit edilemedi. Osteonekroz ve monoartritin aynı anda bulunması başlangıçta hastanın KBAS olarak değerlendirilmesine yol açmıştır. Bu vakayı sunmadaki amacımız hemiplejide KBAS'la karışabilecek bir durumu ortaya koyarak, yanlış tanı konulmasını önlemede farkındalık yaratmaktır. Ayrıca osteonekroz ve inflamatuar monoartrit birlikteliği bu iki durumun birbirleriyle ilişkili olup olmadığı açısından araştırma yapılması gerekliliğini doğurmuştur. Bu vaka sunumunda özellikle inme hastalarında KBAS tip 1 ve osteonekroz tanı ayrımının önemi ortaya çıkmaktadır. Bu iki hastalığın ayırıcı tanısına yönelik hassasiyet gösteril-mesi tanı gecikmesini önleyecektir.A An na ah ht ta ar r K Ke el li im me el le er r: : Osteonekroz; kompleks bölgesel ağrı sendromu; hemipleji; artrit; rehabilitasyon regional pain syndrome (CRPS) is another cause of knee pain and should not be ignored in the diff...

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Section: Discussionmentioning

confidence: 99%

A Condition Confused with Complex Regional Pain Syndrome in Hemiplegia: Simultaneous Occurance of Knee Osteonecrosis and Monoarthritis

Özcan¹,

Köseoğlu²,

Taşkin³

et al. 2018

J PMR Sci

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“…Magnetic resonance imaging (MRI) findings in patients with CRPS‐1 have been equivocal. A recent report showed discernible muscle changes in the acute phase, 27 but other MRI‐based studies have not corroborated these findings 28,29 . The bone demineralization seen on radiographs may not always be present in patients with CRPS‐1, particularly in the initial stages of disease 12 .…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Appearance of Forearm Muscles in 18 Patients With Complex Regional Pain Syndrome 1 of the Upper Extremity

Vas¹,

Pai²,

Mahesh³

2012

Pain Practice

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“…Nedeni tam bilinmemekle birlikte, çoğu olguda travma ya da cerrahi öyküsü bulunur [11]. Kadınlarda 3 kat daha sıktır.…”

Section: Kompleks Bölgesel Ağrı Sendromuunclassified

“…Klinik olarak akut enflamatuar, distrofik ve atrofik olmak üzere 3 evresi vardır. Radyografilerde kemikte mineral kaybı sık görülmekle birlikte, özellikle erken dönemde izlenmeyebilir [11] (Resim 9A). MRG'de; ekleme komşu kemik yüzeylerde daha belirgin difüz KİÖ ile komşu yumuşak doku …”

Section: Kompleks Bölgesel Ağrı Sendromuunclassified

Neoplazik Olmayan Kemik Iligi Bozukluklari

Tokgöz¹

2017

Trd Sem

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Type I complex regional pain syndrome: MRI may be misleading

Cited by 8 publications

References 13 publications

A Condition Confused with Complex Regional Pain Syndrome in Hemiplegia: Simultaneous Occurance of Knee Osteonecrosis and Monoarthritis

A Condition Confused with Complex Regional Pain Syndrome in Hemiplegia: Simultaneous Occurance of Knee Osteonecrosis and Monoarthritis

Ultrasound Appearance of Forearm Muscles in 18 Patients With Complex Regional Pain Syndrome 1 of the Upper Extremity

Neoplazik Olmayan Kemik Iligi Bozukluklari

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