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

Abstract

Ultrasonography provides useful anatomical information, regarding structure, kinesiology, and gross pathological changes of muscle, that may prove useful in understanding the motor impairment associated with CRPS-1. USG shows promise as a cost-effective bedside tool for the diagnosis of CRPS-1 and in guiding physical therapy.

Musculoskeletal Ultrasonography to Distinguish Muscle Changes in Complex Regional Pain Syndrome Type 1 from Those of Neuropathic Pain: An Observational Study

“…We have previously described the USG changes in the forearm muscles affected by CRPS‐1 in 18 patients . The CRPS‐affected muscles demonstrated complete loss of normal architecture.…”

“…The muscles in the normal forearm were first labeled, and the muscles in corresponding locations were considered to represent the same muscles on the NeuP/CRPS‐affected forearm. This was done to identify muscles in patients with CRPS wherein the sonoanatomical loss of myoarchitecture has been observed to be considerable . A similar protocol was followed for labeling the extensor muscles (Figures , Group A; Figures , Group B).…”

Force modulation deficits in complex regional pain syndrome: A potential role for impaired sense of force production

“…The prominent loss of voluntary control is associated with significant disability (Geertzen et al, 1998;Perez et al, 2002;Maihöfner et al, 2003;Savaş et al, 2009;Huge et al, 2011;Marinus et al, 2013). Several pathophysiological mechanisms have been postulated to underpin the CRPS-related motor impairments, ranging from structural and functional alterations in skeletal muscle tissue (van der Laan et al, 1998;Hulsman et al, 2009;Tan et al, 2011;Vas et al, 2013) to maladaptive neuroplasticity at various levels of the central nervous system (Maihöfner et al, 2003;Swart et al, 2009;Marinus et al, 2011). The latter may have profound consequences for motor control, presumably through impaired processing of afferent input and abnormal integration of sensory signals during motor control (Abbruzzese and Berardelli, 2003).…”

Hydroalcoholic crude extract of Casearia sylvestris Sw. reduces chronic post-ischemic pain by activation of pro-resolving pathways

“…Currently, morphological alterations observed during CRPS-I is not related to nerve injury or bone alterations, specially during initial phases of the disease; however, changes in skin, specially in microcirculation, and muscle tissues have been found (Coderre & Bennett, 2010;Millecamps et al, 2010). In muscles, patients who have suffered amputation of the affected limb, presented major disturbances such as fatty degeneration, atrophy of fibers and nuclear agglomeration, not related to the duration of the syndrome, while extensor and flexor muscles of the forearm from other patients were affected as evaluated by ultrassonography (Goebel & Blaes, 2013;Vas et al, 2013;Huang et al, 2011;Schürmann et al, 2007). This results are in accordance with our histological data demonstrating no alterations in cartilage nor pannus formation at the joints of animals from disease group while, in the contrary, skeletal muscle was massively surrounded by infiltration of inflammatory cells which, as expected, were not present in sham group.…”