Synonyms: CRPS, Sudeck’s atrophy, Reflex sympathetic dystrophy, RSD, Causalgia
Chronic regional pain syndrome (CRPS) is a neuropathic pain syndrome that involves both peripheral and central sensitization. There are 2 types of CRPS. In type 1 (Sudeck’s atrophy or Reflex sympathetic dystrophy – RSD), there is no proven nerve injury while in type 2 (Causalgia), there is a known nerve injury.
Budapest Criteria for Clinical Diagnosis
1. Pain (ongoing and disproportionate to any inciting event)
2. Symptoms (reported): At least 1 symptom in 3/4 of the following categories:
- Sensory β Hyperaesthesia and/or allodynia
- Vasomotor β Temperature asymmetry and/or skin colour changes and/or skin colour asymmetry
- Sudomotor/Edema β Edema and/or sweating changes and/or sweating asymmetry
- Motor/Trophic β Decreased range of motion and/or motor dysfunction (weakness, tremor, dystonia) and/or trophic changes (hair, nail, skin)
3. Signs (examined): At least one sign in 2/4 of the following categories:
- Sensory β Hyperalgesia (to pinprick) and/or allodynia (to light touch and/or temperature sensation and/or deep somatic pressure and/or joint movement)
- Vasomotor β Temperature asymmetry (>β1βΒ°C) and/or skin colour changes and/or asymmetry
- Sudomotor/Edema β Edema and/or sweating changes and/or sweating asymmetry
- Motor/trophic β Decreased range of motion and/or motor dysfunction (weakness, tremor, dystonia) and/or trophic changes (hair, nail, skin)
4. Diagnosis of exclusion: No other diagnosis better explains the signs and symptoms.
Mnemonic: CRPS
- Color (Color changes/asymmtery) or Celsius (Temperature asymmetry)
- Reduced motor function (Reduced ROM/weakness/tremor/dystonia) or keratin health (hair, nail, skin changes)
- Pain (essential criteria – out of proportion) + abnormal Pain sensation (hyperalgesia/allodynia)
- Swelling or Sweating (changes/asymmetry)
Diagnosis requires: 1 Pain + 2 Signs + 3 Symptoms
It’s features can also be remembered using the mnemonic: STAMP
- Sensory (Hyperalgesia or Allodynia)
- Trophic (Skin hair, nail, changes)
- Autonomic (Swelling, edema, sweating)
- Motor (Reduced range of motion, weakness, tremor or dystonia)
- Pain