Complex Regional Pain Syndrome (CRPS) : Budapest Criteria

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 – Hyperaesthesia and/or allodynia
  • Vasomotor – Temperature asymmetry and/or skin colour changes and/or skin colour asymmetry
  • Sudomotor/Edema – Edema and/or sweating changes and/or sweating asymmetry
  • Motor/Trophic – 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 – Hyperalgesia (to pinprick) and/or allodynia (to light touch and/or temperature sensation and/or deep somatic pressure and/or joint movement)
  • Vasomotor – Temperature asymmetry (> 1 °C) and/or skin colour changes and/or asymmetry
  • Sudomotor/Edema – Edema and/or sweating changes and/or sweating asymmetry
  • Motor/trophic – 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

  1. Color (Color changes/asymmtery) or Celsius (Temperature asymmetry)
  2. Reduced motor function (Reduced ROM/weakness/tremor/dystonia) or keratin health (hair, nail, skin changes)
  3. Pain (essential criteria – out of proportion) + abnormal Pain sensation (hyperalgesia/allodynia)
  4. Swelling or Sweating (changes/asymmetry)

Diagnosis requires: 1 Pain + 2 Signs + 3 Symptoms

It’s features can also be remembered using the mnemonic: STAMP

  1. Sensory (Hyperalgesia or Allodynia)
  2. Trophic (Skin hair, nail, changes)
  3. Autonomic (Swelling, edema, sweating)
  4. Motor (Reduced range of motion, weakness, tremor or dystonia)
  5. Pain


Write your Viewpoint 💬

Your email address will not be published. Required fields are marked *