Zych-Litwin Cecylia, Litwin Jan A
Division of Rheumatology, MEDDIM Specialized Medical Center for Children and Adolescents, Cracow, Poland.
Department of Histology, Jagiellonian University Medical College, Cracow, Poland.
Reumatologia. 2019;57(2):117-119. doi: 10.5114/reum.2019.84818. Epub 2019 Apr 29.
The case report describes a 67-year-old man who suffered from a minor left ankle injury. Physical examination on day 12 revealed swelling of the foot, erythema on its dorsal surface as well as elevated temperature, hyperesthesia, hyperalgesia and allodynia of that area. The treatment included local application of dexamethasone and oral administration of meloxicam. Within a week the symptoms disappeared and one-year follow-up did not show their recurrence. The presented symptoms allowed diagnosis of the earliest stage of complex regional pain syndrome (CRPS), which may be a disabling and difficult to treat adverse event. This report suggests that immediately introduced simple anti-inflammatory therapy may bring a quick and permanent recovery. Hence, first contact physicians should advise the patient to report such symptoms as burning pain of the injured area lasting for a few days and, if CRPS suspicion is justified by the results of physical examination, they should apply an anti-inflammatory treatment immediately.
该病例报告描述了一名67岁男性，他左脚踝受了轻伤。第12天的体格检查发现足部肿胀，足背皮肤发红，且该区域温度升高、感觉过敏、痛觉过敏和感觉异常。治疗包括局部应用地塞米松和口服美洛昔康。一周内症状消失，一年的随访未显示复发。所呈现的症状有助于诊断复杂区域疼痛综合征（CRPS）的最早阶段，这可能是一种致残且难以治疗的不良事件。本报告表明，立即采用简单的抗炎治疗可能带来快速且持久的康复。因此，首诊医生应建议患者报告受伤区域持续数天的灼痛等症状，并且如果体格检查结果证实怀疑为CRPS，应立即进行抗炎治疗。
