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Complex regional pain syndromes (CRPS) (Diagnosis (History (PMH Growth…
Complex regional
pain syndromes (CRPS)
Management
Conservative
Information, advice, support
Physiotherapy (rehab regimen)
Psychologists
Definition
Orthopedic disorder of pain
and sensory abnormalities
Epidemiology
Adolescent females
Pathophysiology
Defect
Unclear cause, likely multifactorial (stress)
Localised often triggered by minor trauma
Mechanism
Localised or generalised pain,
often extreme and debilitating
Clinical
presentation
Localised
Unilateral foot/ankle pain
Hyperaesthesia
Allodynia
Diffuse
Severe widespread pain
Disturbed sleep
Daytime fatigue
Diagnosis
Examination
Musculoskeletal exam
Cool temp, swelling, mottling
Minimal active movement, bizarre posturing
Passive movmement normal (with distraction)
Soft tissue tenderness
Investigations
Bedside
Obs (nil)
Bloods
FBC, CRP, U+E, LFT, TFTs
Autoimmune screen (all nil)
Imaging
X-ray ankle/foot (nil, may have patchy osteopenia)
History
PMH
Growth and development
Known medical conditions
DH
Meds, allergies
PC/HPC
Severe, debilitating pain, often minor trigger,
pain sensitivity (painful and non-painful stimuli)
FH
Pain disorders
Orthopedic disorders
SH
Living arrangements, school,
smoking, alcohol