The Hospital for Sick Children, Department of Rehabilitation, and the University of Toronto, Department of Physical Therapy, Toronto, ON, Canada.
The Hospital for Sick Children, Child Health Evaluative Sciences, Toronto, ON, Canada.
Pain. 2021 May 1;162(5):1295-1304. doi: 10.1097/j.pain.0000000000002146.
Complex regional pain syndrome (CRPS) is a severely painful condition that presents with a constellation of symptoms. The understanding of the pathophysiology of CRPS has evolved over time, as have the diagnostic criteria. Our primary objective was to identify screening and diagnostic tools for CRPS and summarize their feasibility, measurement properties, and study quality. A secondary objective was to identify screening and diagnostic tools used for CRPS in pediatric populations (0-21 years of age). A systematic review of English articles in electronic databases (PsycINFO, MEDLINE, Embase, CINAHL, CENTRAL, and Web of Science) was conducted with the aid of a librarian in November 2018 and updated in July 2020. Studies were included if the tool was a screening or diagnostic tool, the tool included self-report or physical examination, and the primary objective of the study was to evaluate the measurement properties or feasibility of use. For each study, data were extracted for quality indicators using the QUADAS-2 tool. No screening tools were identified. Four diagnostic tools were identified: the Veldman criteria, International Association for the Study of Pain criteria, Budapest Criteria, and Budapest Research Criteria. There are no diagnostic tools validated for use in pediatric CRPS. Because there are no extant screening tools for CRPS, all people with suspected disease should undergo rapid diagnostic assessment by a clinician. For adults, the Budapest Criteria are the preferred diagnostic tool. Future research is recommended to develop a diagnostic tool for pediatric populations and screening tools for both pediatric and adults.
复杂性区域疼痛综合征（CRPS）是一种严重的疼痛病症，表现为一系列症状。随着时间的推移，CRPS 的病理生理学理解和诊断标准也在不断发展。我们的主要目标是确定 CRPS 的筛查和诊断工具，并总结其可行性、测量特性和研究质量。次要目标是确定用于儿科人群（0-21 岁）的 CRPS 筛查和诊断工具。在 2018 年 11 月，我们在图书馆员的帮助下对电子数据库（PsycINFO、MEDLINE、Embase、CINAHL、CENTRAL 和 Web of Science）中的英文文章进行了系统评价，并在 2020 年 7 月进行了更新。如果工具是筛查或诊断工具，工具包括自我报告或体格检查，并且研究的主要目的是评估测量特性或使用可行性，则纳入研究。对于每项研究，使用 QUADAS-2 工具提取质量指标的数据。没有发现筛查工具。确定了四种诊断工具：Veldman 标准、国际疼痛研究协会标准、布达佩斯标准和布达佩斯研究标准。没有经过验证可用于儿科 CRPS 的诊断工具。由于目前尚无 CRPS 的筛查工具，所有疑似疾病的人都应由临床医生进行快速诊断评估。对于成年人，布达佩斯标准是首选的诊断工具。建议未来开展研究，为儿科人群开发诊断工具，并为儿科和成年人开发筛查工具。
