What are the clinical diagnostic criteria for complex regional pain syndrome (CRPS)?

Updated: Jun 20, 2018
  • Author: Gaurav Gupta, MD; Chief Editor: Stephen A Berman, MD, PhD, MBA  more...
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Answer

A clinical diagnosis of CRPS can be made when the following criteria are met:

  • Continuing pain that is disproportionate to any inciting event

  • At least 1 symptom reported in at least 3 of the following categories:

    • Sensory: Hyperesthesia or allodynia

    • Vasomotor: Temperature asymmetry, skin color changes, skin color asymmetry

    • Sudomotor/edema: Edema, sweating changes, or sweating asymmetry

    • Motor/trophic: Decreased range of motion, motor dysfunction (eg, weakness, tremor, dystonia), or trophic changes (eg, hair, nail, skin)

  • At least 1 sign at time of evaluation in at least 2 of the following categories:

    • Sensory: Evidence of hyperalgesia (to pinprick), allodynia (to light touch, temperature sensation, deep somatic pressure, or joint movement)

    • Vasomotor: Evidence of temperature asymmetry (>1°C), skin color changes or asymmetry

    • Sudomotor/edema: Evidence of edema, sweating changes, or sweating asymmetry

    • Motor/trophic: Evidence of decreased range of motion, motor dysfunction (eg, weakness, tremor, dystonia), or trophic changes (eg, hair, nail, skin)

  • No other diagnosis better explaining the signs and symptoms

In addition, a slightly modified version of the above listing is used for CRPS research (as opposed to clinical) criteria. For these rules one must have the CRPS characteristics present in all four of the symptom categories and in at least two out of the four sign categories.


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