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

Updated: Nov 08, 2018
  • Author: Steven J Parrillo, DO, FACOEP, FACEP; Chief Editor: Andrew K Chang, MD, MS  more...
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Answer

Brunner et al performed a Delphi survey among international experts. [27] The survey asked those experts to list and grade diagnostic and follow-up parameters for CRPS I. Although there was some disagreement about weighting, the consensus follows.

The 3 diagnostic parameters, each with a subcategory, are listed below.

  • Pain

    • Hyperesthesia

    • Hyperalgesia

    • Allodynia

  • Signs

    • Edema

    • Color

  • Mobility

    • Motor change

    • Range of motion

    • Strength

The one follow-up parameter is clinical course. The subcategories are as follows:

  • Decrease in pain

  • Decrease in hyperalgesia

  • Decreased edema

  • Improvement in motor function

  • Improvement in strength

The experts from this survey also agreed that the diagnosis can and should be established without additional studies (radiography, scintigraphy). [27] Other authors believe likewise. [28] Much of the older RSDS literature notes a predisposing personality of depression. However, many other studies have demonstrated that, while most patients are depressed, they are depressed because of their pain. (See Causes below.)


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