Brian P. Jacob, David C. Chen, Bruce Ramshaw, Shirin Towfigh (eds.) - The SAGES Manual of Groin Pain-Springer International Publishing (2016)

20
P. Vahedifar and E. Kamrava
Table 3.1. Criteria for diagnosis of CRPS, per International Association for the
Study of Pain.
1. Continued pain that is disproportionate to the inciting event
2. No other diagnosis better explains the signs and symptoms
3. Signs and symptoms below
Symptom (complaint) Sign (physical exam)
Sensory
Vasomotor
Sudomotor/
edema
Motor/trophic
At least 1 symptom in at
least 3 of the following
categories
− Hyperesthesia
− Allodynia
− Temperature asymmetry
− Skin color changes
− Skin color asymmetry
− Edema
− Sweating changes
− Sweating asymmetry
− Decreased range of
motion
− Motor dysfunction such
as weakness, tremor,
dystonia
− Trophic changes such as
hair, nail, or skin changes
At least 1 sign at the time of
evaluation in at least 2 of the
following categories
− Hyperalgesia to pin prick
− Allodynia to light touch
− Allodynia to temperature
sensation
− Allodynia to deep somatic
pressure
− Allodynia to joint movement
− Temperature asymmetry
greater than 1 °C
− Skin color changes
− Skin color asymmetry
− Edema
− Sweating changes
− Sweating asymmetry
− Decreased range of motion
− Motor dysfunction such as
weakness, tremor, dystonia
− Trophic changes such as
hair, nail, or skin changes
Adapted from Harden et al. [ 3 ], with kind permission John Wiley & Sons
Pharmacologic Treatment
Oral pharmacological treatment of CRPS has shown beneficial treatment
with early-onset CRPS. The use of corticosteroids in early stages
of CRPS has proven effective in some patients. Kozin et al. demonstrated
that the pulsed use of steroids in patients with chronic regional
pain syndrome showed improvement in 60–80 % of patients after
2 weeks [ 7 ]. Similarly, Christensen et al. confirmed decrease in pain in
the first 3–4 months [ 8 ]. Farah et al. have also shown effectiveness of
NSAIDS in some forms of CRPS in early stages of disease [ 9 ].