scholarly journals Complex Regional Pain Syndrome-Type 1 Presenting as deQuervain’s Stenosing Tenosynovitis

2016 ◽  
Vol 1;19 (1;1) ◽  
pp. E227-E234 ◽  
Author(s):  
Lakshmi Vas
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
Dry Needling ◽  
Ultrasound Guided ◽  
Extensor Muscles ◽  
Patient Health ◽  
Stenosing Tenosynovitis ◽  
History Of ◽  
Musculoskeletal Ultrasonography ◽  
Conservative And Surgical Treatment

Aim: To report the presentation of complex regional pain syndrome-1 (CRPS-1) as deQuervain’s stenosing tenosynovitis (DQST). Case report: A 24-year-old woman presented with 3-year history of clinical diagnostic criteria (CDC) of CRPS-1. Conservative and surgical treatment for this as DQST had failed to relieve her. We diagnosed the problem as CRPS-1with CDC as inflammatory manifestations of a mechanical tendinoses of all her 5 digital tendons caused by movement of the fingers and hand tethered by agonist (flexor)/ antagonist (extensor) muscles in co-contraction. Ultrasound guided dry needling (USGDN) relaxed the muscles, replacing the abnormal agonist/antagonist co-contraction with normal agonist/antagonist coordination. Resolution of tendinoses reversed the inflammation causing the CDC. Six months later she leads normal personal and professional life, with reduction of scores of painDetect (from 21 to 5), Patient Health Questionnaire (from 13 to 4), Disability of arm, shoulder and hand from 70.8 to 25 and reversal of muscle abnormality characteristic of CRPS1 on Musculoskeletal Ultrasonography (MSKUSG). Conclusion: We believe the primary pathology of CRPS-1 to be co-contraction of agonist (flexor)/antagonist(extensor) muscles of digits resulting in tendinoses akin to DQST. CDC of CRPS are actually inflammatory manifestations of tendinoses amenable to reversal by USGDN which also addresses the disability, a hallmark of CRPS. Key words: Complex regional pain syndrome-1 (CRPS-1), deQuervain’s stenosing tenosynovitis (DQST), neuropathy, co-contraction, dry needling (DN), ultrasound guided dry needling (USGDN), musculoskeletal ultrasonography (MSKUSG)

scholarly journals Venipuncture Induced Complex Regional Pain Syndrome Presenting as Inflammatory Arthritis

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Punit Pruthi ◽  
Pramod Arora ◽  
Manoj Mittal ◽  
Anugrah Nair ◽  
Waqia Sultana
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Inflammatory Arthritis ◽  
Young Male ◽  
Pain Syndrome ◽  
Poor Response ◽  
History Of ◽  
Diagnostic Modalities ◽  
Musculoskeletal Ultrasonography ◽  
The Right

Venipuncture is one of the most commonly done medical procedures. We report a unique case of a 23-year-old young male who presented with features suggestive of inflammatory arthritis. The symptoms, which initially started on the right side, also involved the other side after a few weeks. Although the patient’s symptoms and signs were simulating inflammatory arthritis, he had atypical features like poor response to anti-inflammatory medicines and normal laboratory parameters. His musculoskeletal ultrasonography was also not suggestive of arthritis. His history was reviewed and on direct questioning he revealed a history of venipuncture for blood sample withdrawal, done from right antecubital region for routine health check on the day prior to the onset of symptoms. Complex regional pain syndrome was suspected and triple-phase radioisotope bone scan was done which was highly suggestive of this diagnosis. The patient was managed with multidimensional approach and responded very well to the treatment. Complex regional pain syndrome is usually not thought of in the initial differential diagnosis of inflammatory arthritis. In this report we highlight the need to elicit the often overlooked history of trivial trauma like venipuncture, especially in atypical cases of arthritis. Also the role of newer diagnostic modalities in such cases is emphasized.

scholarly journals Atypical presentation of complex regional pain syndrome: neuropathic itching - A case report -

2021 ◽  
Author(s):  
Syn-Hae Yoon ◽  
Woojong Cho ◽  
Juhan Mun ◽  
Wonyeong Jeong ◽  
Young Do Kim ◽  
...  
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
Treatment Modalities ◽  
Atypical Presentation ◽  
Foot And Ankle ◽  
Main Symptom ◽  
Hypoxic Brain Damage ◽  
Hypoxic Brain ◽  
History Of ◽  
Ankle Mobility

Background: In some patients with neuropathic pain (NP), such as complex regional pain syndrome (CRPS), itching rather than pain is the main symptom making diagnosis and treatment difficult.Case: We report a case of a 23-year-old man with a history of hypoxic brain damage who presented with pruritus of the left foot and ankle. His left foot was fractured, and he underwent surgery 6 months previously. After the operation and cast application, he developed uncontrolled pruritus, swelling, sweating, and flushing of the left foot skin with limping. On examination, he showed well-known features of CRPS without pain. He was diagnosed with an atypical CRPS with neuropathic itching (NI). With treatment modalities used for NP and CRPS, his pruritus subsided gradually, and the his ankle mobility improved.Conclusions: Unexplained itching can be the main symptom in some CRPS patients. Treatment according to NP can improve symptoms of NI in CRPS patients.

scholarly journals Familial Occurrence of Complex Regional Pain Syndrome

2010 ◽  
Vol 37 (3) ◽  
pp. 389-394 ◽  
Author(s):  
Peyman Shirani ◽  
Ali Jawaid ◽  
Paolo Moretti ◽  
Elham Lahijani ◽  
Alicia R. Salamone ◽  
...  
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Clinical Features ◽  
Genetic Basis ◽  
Genetic Factors ◽  
Age At Onset ◽  
Pain Syndrome ◽  
Case Histories ◽  
Younger Age ◽  
History Of ◽  
Pain Symptoms

Background:The etiology of complex regional pain syndrome (CRPS) is unknown. Different environmental and genetic factors have been postulated to contribute to CRPS.Methods:We reviewed the clinical data from a cohort of 69 patients with CRPS. Four families were identified with two or more members affected with CRPS yielding a total of nine patients. Six more patients reported the presence of pain symptoms in their family members, however; this could not be clinically confirmed.Results:The case histories of the nine individuals with ‘familial’ CRPS suggested a younger age at onset and more frequent history of migraine versus the non-familial patients. A pattern of inheritance could not be ascertained.Conclusion:This data supports the hypothesis that CRPS can be familial and hence may have a genetic basis in some families. Larger studies will be needed to ascertain clearer patterns of inheritance and to determine whether the clinical features of ‘familial’ CRPS are the same as the sporadic form.

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