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CRPS - further information for Professionals

Diagnosis of CRPS

CRPS is more common than often thought and should be considered in patients with disproportionate levels of pain, often burning or with allodynia, after minor injuries or surgery, normally in the peripheries.  

Diagnosis is primarily clinical.  The Budapest Criteria are used in diagnosis:

  • continuing pain disproportionate to any inciting event
  • at least 1 symptom in 3 of the 4 following categories:
    • sensory:
      • hyperaesthesia
      • allodynia
    • vasomotor:
      • temperature asymmetry
      • skin colour changes
      • skin colour asymmetry
    • sudomotor/oedema:
      • oedema changes
      • sweating changes
      • sweating asymmetry
    • motor/trophic:
      • decreased range of motion
      • motor dysfunction
      • trophic changes − abnormal hair, nail, or skin growth
  • at least 1 sign at time of evaluation in 2 or more of the following categories
    • sensory:
      • hyperalgesia to pinprick
      • allodynia to light touch, and/or deep somatic pressure, and/or joint movement
    • vasomotor:
      • temperature asymmetry
      • skin colour changes and/or asymmetry
    • sudomotor/oedema:
      • oedema
      • sweating changes
      • sweating asymmetry
    • motor/trophic:
      • decreased range of motion
      • motor dysfunction − weakness, tremor, dystonia
      • trophic changes − hair, nail, skin
  • no other diagnosis to explain the signs and symptoms

The principles applied to the diagnosis and management of CRPS are similar between type I and type II.

NB: An early diagnosis allows treatment to be implemented sooner, in the hope of curing or mitigating the disease − if undiagnosed and untreated, CRPS can spread, and treatment is much less successful later in the course of the condition.

The pathway on CRPS in Map of Medicine is a useful resource.

 

There is a useful summary on the professional pages in the Patient.co.uk site

 

 

 

 

 

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Pain Service Website, Gloucestershire Hospitals NHS Foundation Trust
Webmaster Dr J G de Courcy, Consultant in Pain Medicine and Anaesthesia
email: pain.webmaster[at]glos.nhs.uk

Page updated 15/02/2016