CRPS Flashcards
what is the pathogenesis of CRPS? (3)
classic inflammation
neurogenic inflammation
maladaptive changes in pain perception at CNS
what is the clinical presentation of a patient with CRPS? (3)
pain/hyperalgesia
burning/stinging/tearing deep inside the limb
allodynia
a patient presents with pain, erythema, and swelling in a limb about 4-6 weeks after an inciting event. Dx?
stage 1 CRPS
what are the 4 most common inciting event of CRPS?
fractures
crush injuries
sprains
surgery
where does CRPS most commonly begin?
upper limb
progression of edema in the soft tissue, thickening of skin and articular soft tissues, muscular wasting, and development of brawny skin
stage 2 CRPS
how long does stage 2 of CRPS typically last?
3-6 months
limited movement, shoulder-hand syndrome, contractures of digits, waxy trophic skin changes, bone demineralization, and brittle/ridged nails.
stage 3 CRPS
capsular retraction producing a frozen shoulder
shoulder-hand syndrome
how is CRPS diagnosed?
clinical
no gold standard
what diagnostic can be used to detect alterations in bone metabolism in patients with CRPS who have active bone resorption?
bone scan
what diagnostic can be used to find patchy osteoporosis?
plain film
what is the management for CRPS? (2)
vitamin C
early mobilization after limb injury
what pharmacotherapy can be used for CRPS? (2)
ibuprofen / naproxen
amitriptyline / nortripytline
what meds can be used for neuropathic pain? (2)
gabapentin
lidocaine cream / topical capsaicin
what 2 meds can be used to decrease bone resorption?
bisphosphonates
calcitonin
what medication can be used in CRPS if the patient does not get any relief from other medications?
glucocorticoids - prednisone
what should be done if a patient with CRPS has an unknown MOA of analgesia?
spinal cord stimulation
what can cause recurrence of CRPS? (3)
cold exposure
new surgery
emotional trauma
when can elective surgery for CRPS be done?
only when previous episodes have resolved
