Department of Neurology, General Hospital Fürth, Fürth, Germany; Faculty of Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany; Department of Neurology, University Hospital Erlangen, Erlangen, Germany.
Department of Neurology, General Hospital Fürth, Fürth, Germany; Faculty of Medicine, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
J Pain. 2018 Jun;19(6):599-611. doi: 10.1016/j.jpain.2018.01.004. Epub 2018 Feb 2.
Complex regional pain syndrome (CRPS) is a complex pain disorder that can emerge after limb trauma or a lesion in the peripheral nervous system. Typical features include continuing pain, sensory, vasomotor, sudomotor, motor, and trophic changes as well as edema. These signs provide the basis of CRPS diagnosis. A detailed description of the signs, symptoms, and medical history of CRPS could potentially facilitate an earlier and more accurate diagnosis. The aim of this study was to provide such a description, on the basis of epidemiological measures, clinical presentation, and a thorough description of pain sensations. Some signs (eg, differences of skin temperature >1°C), which have been thought to be crucial for diagnosis, were less common than assumed. We identified 11 distinct etiological triggers, which cover more than 99% of the study participants. We developed a weighted score on the basis of the most decisive data, which achieved a sensitivity of .869 and a specificity of .829, compared with .819 and .679 for the Budapest criteria. The weighted diagnostic criteria may help to better aid in distinguishing CRPS from other pain disorders.
This article provides a retrospective epidemiological analysis of 1,043 CRPS patients compared with 421 patients with other pain disorders. The findings could potentially facilitate a more reliable and earlier diagnosis of CRPS, a better differentiation from other pain disorders, and ultimately in a more targeted and effective therapy.
复杂区域疼痛综合征（CRPS）是一种复杂的疼痛障碍，可能在肢体创伤或周围神经系统损伤后出现。典型特征包括持续疼痛、感觉、血管运动、出汗、运动和营养变化以及水肿。这些迹象为 CRPS 的诊断提供了依据。详细描述 CRPS 的体征、症状和病史可能有助于更早、更准确地诊断。本研究的目的是在流行病学措施、临床表现和对疼痛感觉的详细描述的基础上提供这样的描述。一些被认为对诊断至关重要的迹象（例如，皮肤温度差异>1°C）比想象的要少见。我们确定了 11 个不同的病因触发因素，这些触发因素涵盖了超过 99%的研究参与者。我们根据最具决定性的数据制定了加权评分，与布达佩斯标准的.819 和.679 相比，其敏感性为.869，特异性为.829。加权诊断标准可能有助于更好地区分 CRPS 与其他疼痛障碍。
本文对 1043 例 CRPS 患者和 421 例其他疼痛障碍患者进行了回顾性流行病学分析。这些发现可能有助于更可靠、更早地诊断 CRPS，更好地区分 CRPS 与其他疼痛障碍，并最终实现更有针对性和更有效的治疗。
