Criteria for diagnosis
A diagnosis of Complex Regional Pain Syndrome (CRPS) was made based on the Budapest Criteria.
Historically, the diagnosis of CRPS was difficult to make and reflected an array of idiosyncratic diagnostic schemes leading to over diagnosis of neuropathic pain as CRPS, and potentially causing unnecessary treatments. The International Association for the Study of Pain (ISAP) convened an international panel of experts to suggest an improved diagnostic criteria who met in Budapest, and the resultant proposal for modified diagnostic criteria for CRPS (the “Budapest Criteria”) was adopted by ISAP and remains the most clinically used criteria for CRPS diagnosis.
To make the clinical diagnosis of CRPS, the following criteria must be met:
1. Continuing pain, which is disproportionate to any inciting event
2. Must report at least one symptom in three of the four following categories:
- Sensory: reports of hyperaesthesia and/or allodynia
- Vasomotor: reports of temperature asymmetry and/or skin colour changes and/or skin colour asymmetry
- Sudomotor/Oedema: reports of oedema and/or sweating changes and/or sweating asymmetry
- Motor/Trophic: reports of decreased range of motion and/or motor dysfunction (weakness, tremor, dystonia) and/or trophic changes (hair, nail, skin)
3. Must display at least one sign at time of evaluation in two or more of the following categories:
- Sensory: evidence of hyperalgesia (to pinprick) and/or allodynia (to light touch and/or deep somatic pressure and/or joint movement)
- Vasomotor: evidence of temperature asymmetry and/or skin colour changes and/or asymmetry
- Sudomotor/Oedema: evidence of oedema and/or sweating changes and/or sweating asymmetry
- Motor/Trophic: evidence of decreased range of motion and/or motor dysfunction (weakness, tremor, dystonia) and/or trophic changes (hair, nail, skin)
4. There is no other diagnosis that better explains the signs and symptoms.
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