Which clinical history findings are characteristic of complex regional pain syndrome (CRPS) type I?

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

No specific diagnostic tests identify the presence of CRPS and no objective guidelines verify its existence. The current criteria for diagnosing CRPS are based mainly on physical examinations and a careful analysis of patient history.

Often, symptoms of CRPS type I begin immediately, days, or weeks after an injury, usually in a distal extremity. Rarely, the onset can be months after the injury. Usually, only one limb is involved, but in a few cases, the involvement is bilateral (4-5%), and even more rarely, 3 or 4 extremities are affected. CRPS type I can be acute (lasting < 2 months) or chronic (>2 months). Approximately half of patients with CRPS type I report it to be related to an on-the-job injury.

Clinical features of CRPS type I are influenced by the following:

  • Duration: As many as 80% of patients with the initial symptoms of CRPS type I are cured within 18 months from its onset, either spontaneously or with treatment. A longer duration of CRPS is related to a significantly greater likelihood of abnormalities of sensation and less of sweating abnormalities or edema.

  • Location: Pain and other symptoms can be located anywhere in the body. The extremities are involved most often, although other locations such as external genitalia or the nose may also be involved. Patients may have pain at the ulnar styloid process after a Colles fracture or at the lateral malleolus after a sprain. Frozen shoulder and/or tendinitis of the biceps often accompany CRPS type I in the hand.


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