TY  - CHAP
M1  - Book, Section
TI  - Complex Regional Pain Syndrome
A1  - Yazdany, Jinoos
A1  - Manno, Rebecca L.
A2  - Papadakis, Maxine A.
A2  - McPhee, Stephen J.
A2  - Rabow, Michael W.
A2  - McQuaid, Kenneth R.
PY  - 2022
T2  - Current Medical Diagnosis & Treatment 2022
AB  - Complex  regional  pain  syndrome  (formerly  called  reflex  sympathetic  dystrophy)  is  a  rare  disorder  of  the  extremities  characterized  by  autonomic  and  vasomotor  instability.  The  cardinal  symptoms  and  signs  are  pain  localized  to  an  arm  or  leg,  swelling  of  the  involved  extremity,  disturbances  of  color  and  temperature  in  the  affected  limb,  dystrophic  changes  in  the  overlying  skin  and  nails,  and  limited  range  of  motion.  Strikingly,  the  findings  are  not  limited  to  the  distribution  of  a  single  peripheral  nerve.  Most  cases  are  preceded  by  surgery  or  direct  physical  trauma,  often  of  a  relatively  minor  nature,  to  the  soft  tissues,  bone,  or  nerve.  Early  mobilization  after  injury  or  surgery  reduces  the  likelihood  of  developing  the  syndrome.  Any  extremity  can  be  involved,  but  the  syndrome  most  commonly  occurs  in  the  hand  and  is  associated  with  ipsilateral  restriction  of  shoulder  motion  (“shoulder-hand”  syndrome).  This  syndrome  proceeds  through  phases:  pain,  swelling,  and  skin  color  and  temperature  changes  develop  early  and,  if  untreated,  lead  to  atrophy  and  dystrophy.  The  swelling  in  complex  regional  pain  syndrome  is  diffuse  (“catcher’s  mitt  hand”)  and  not  restricted  to  joints.  Pain  is  often  burning  in  quality,  intense,  and  often  greatly  worsened  by  minimal  stimuli  such  as  light  touch.  The  shoulder-hand  variant  of  this  disorder  sometimes  complicates  myocardial  infarction  or  injuries  to  the  neck  or  shoulder.  Complex  regional  pain  syndrome  may  occur  after  a  knee  injury  or  after  arthroscopic  knee  surgery.  There  are  no  systemic  symptoms.  In  the  early  phases  of  the  syndrome,  bone  scans  are  sensitive,  showing  diffuse  increased  uptake  in  the  affected  extremity;  radiographs  eventually  reveal  severe  generalized  osteopenia.  In  the  posttraumatic  variant,  this  is  known  as  Sudeck  atrophy.  Symptoms  and  findings  are  bilateral  in  some.  This  syndrome  should  be  differentiated  from  other  cervicobrachial  pain  syndromes,  rheumatoid  arthritis,  thoracic  outlet  obstruction,  and  systemic  sclerosis,  among  others.  
SN  - 
PB  - McGraw-Hill Education
CY  - New York, NY
Y2  - 2024/04/19
UR  - accessmedicine.mhmedical.com/content.aspx?aid=1184193680
ER  -