Diagnosis of complex regional pain syndrome type I of the upper extremity: Role of dual energy X-ray absorptiometry and three-phase bone scintigraphy

摘要

Objective: The aim of the present study was to evaluate and compare the role of dual energy X-ray absorptiometry andthree-phase bone scintigraphy in the diagnosis of complex regional pain syndrome type I of upper extremity.Methods: Five male and nineteen female patients diagnosed with complex regional pain syndrome type I (CRPSI) were includedin this study. Three-phase bone scintigraphy (TPBS), bone mineral density (BMD) and bone mineral content (BMC) of wrist,metacarpophalangeal joint (MCP) and proximal interphalangeal (PIP) area in the affected and unaffected hands of patients weremeasured simultaneously using dual energy X-ray absorptiometry (DEXA). The time passed between the precipitating event andclinical onset of CRPSI was also recorded.Results: TPBS findings were in agreement with CRPSI diagnosis in 96% of the patients (23 of 24 patients). Periarticular BMDand BMC values in wrist, MCP, and PIP joints were statistically lower in affected hands than in unaffected hands for all threeregions. Moreover, we found no correlation between BMD or BMC values with the sex, age, dominant hand, and the durationbetween the clinical onset of CRPSI and its precipitating event.Conclusion: The present study suggests that beside TPBS, a valuable tool in the early diagnosis of CRPSI, DEXA can also beused in the determination of early demineralization of bones in CRPSI patients. DEXA is an accurate, noninvasive, rapid, andsafe device for quantitative assessment of unilateral bone loss caused by upper limb CRPSI.