Complex regional pain syndrome underdiagnosedCRPS type 1 is an under-recognized problem in limbs recovering from fracture or immobilized post-stnoke

摘要

Complex regional pain syndrome (CRPS) type 1 may be diagnosed by history and physical exam with no further testing (B). Several different diagnostic criteria have undergone validity testing: the 1993 IASP criteria, Bruehl's criteria, and Veldman's criteria; there is no compelling reason to recommend 1 set of criteria over the others (C).Some cases of CRPS type 1 may be preventable. Some cases of CRPS type 1 in post-stroke upper extremity hemiplegia (also known as shoulder-hand syndrome) may be prevented by early inpatient rehabilitation (C) and avoidance of shoulder trauma to the affected arm (B). Some cases of post-fracture CRPS type 1 may be prevented with 500 mg vitamin C daily started upon diagnosis of fracture and continued through healing (B).