What is the role of bone scintigraphy in the workup of 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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  • Compared with radiography, 3-phase bone scintigraphy has higher sensitivity (97% vs 73%) and specificity (86% vs 57%) in early postfracture CRPS. [60]

  • 3-phase bone scintigraphy can provide valuable information during the first year and is useful in differentiating CRPS from other pain syndromes. [61] Homogeneous unilateral hypoperfusion in the perfusion and blood-pool phases is considered characteristic of CRPS and repudiates osteoporosis due to inactivity. These 2 initial phases are seen at 30 seconds and 2 minutes postinjection, respectively. At 3 hours postinjection, the mineralization phase shows increased unilateral periarticular uptake. This pathological uptake is thought to be highly sensitive and specific to CRPS. [60, 62] On the other hand, scintigraphy only shows significant changes during the first year. Additionally, this test is less valuable in children than in adults due to its higher variability. [63]

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