Despite clinical similarities there are significant differences between acute limb trauma and complex regional pain syndrome I (CRPS I)

  title={Despite clinical similarities there are significant differences between acute limb trauma and complex regional pain syndrome I (CRPS I)},
  author={Frank Birklein and Wolfgang W F K{\"u}nzel and Nicole Sieweke},

Figures and Tables from this paper

Sympathetic dysfunction as a temporary phenomenon in acute posttraumatic CRPS I
Sympathetic dysfunction is regularly seen at the onset of CRPS I and normalizes during the course of the disease, which suggests a posttraumatic sympathetic deficit playing a decisive role in the genesis ofCRPS I.
Experimental approach to CRPS
Delayed recovery and late development of complex regional pain syndrome in patients with an isolated fracture of the distal radius: prediction of a regional inflammatory response by early signs.
It is suggested that patients with a distal radial fracture and a regional inflammatory score of 5 points or more at eight to nine weeks after injury should be considered for specific anti-inflammatory treatment.
Identification of complex regional pain syndrome in the upper limb: Skin temperature asymmetry after cold pressor test
This study adds further support for the accuracy of SkTA as a diagnostic indicator of CRPS to larger studies, which should also seek to replicate the findings for SkTA in the lower limbs.
The incidence of complex regional pain syndrome (CRPS) post trauma and the possible role of tight plaster of Paris in the aetiology of CRPS
According to the Budapest criteria, which are far more stringent than the International Association for the Study of Pain (IASP) criteria, any other possible diagnosis or explanation for the symptoms should be considered first before invoking a diagnosis of CRPS.
Are the complex regional pain syndromes due to neurogenic inflammation?
Whether RSD and causalgia are pathologic expressions of the normal responses to injury and whether an abnormality of the neural contribution to inflammation or “neurogenic” inflammation is emphasized.
Clinical expression profiles of complex regional pain syndrome, fibromyalgia and a-specific repetitive strain injury: More common denominators than pain?
A systematic evaluation of patients with a suspected diagnosis of CRPS, FM or RSI may lead to a better appreciation of the differences and similarities in these diseases and help to unravel the underlying mechanisms.


Vascular abnormalities in acute reflex sympathetic dystrophy (CRPS I): complete inhibition of sympathetic nerve activity with recovery.
Demonstrated for the first time is a complete functional loss of cutaneous sympathetic vasoconstrictor activity in an early stage of RSD/CRPS I with recovery, and results of investigations in healthy subjects ruled out the possibility that antidromic vasodilation caused by activation of nociceptive afferents is responsible for the complete depression of sympathetic vasoluntary reflexes.
The spinal component to skin blood flow abnormalities in reflex sympathetic dystrophy.
This study indicates that there is a spinal component to microcirculatory abnormalities at stage I of the reflex sympathetic dystrophy syndrome that most likely acts through neural (antidromic vasodilator) mechanisms and that may be initiated by traumatic excitation of a peripheral nerve on the clinically affected side.
Sympathectomy for reflex sympathetic dystrophy: Factors affecting outcome
Surgical sympathectomy should be confined to patients with stage II disease who have had an excellent response to chemical sympathetic block and when relief from repeated sympathetic block becomes less effective and the response is dramatic but of shorter duration.
The effects of diuretics on posttraumatic joint stiffness and limb swelling in a rabbit periarticular fracture model.
The marked effect of diuretics on joint stiffness and their minimal effect on limb swelling were unexpected results and indicate a complex, still poorly understood sequence of events leading to joint stiffness after periarticular injury.