Abstract
BackgroundThe partial form of the complex regional pain syndrome of the hand type 1 (CRPS 1), involving only 1 to 3 fingers, is a rare condition first described in 1972. The aim of the study is to define more precisely the diagnosis workup and the prognosis of this clinical entity.MethodsRetrospective study of CRPS1 partial form observed during five years in a rehabilitation ward. Application of The Budapest criteria, evaluation of radiological exams, therapeutic results and vocational outcomes. Comparison with cases from literature review.Results132 patients were hospitalized with the diagnosis of CRPS type 1 of the hand. 16 partial forms were isolated: 11 men, 5 women with a mean age of 43 years. Among these patients, 14 (88%) met The Budapest criteria and the two remaining cases were diagnosed by using the three phase bone scintigraphy. Only moderate improvement was obtained in the majority of the patients. At the maximal time of follow-up (4 to 9 years), 50% of the patients hadn’t returned to work. From the literature review, 19 cases were eligible for clinical comparisons. The main differences between our series and the literature were: more men involved, later diagnosis and worst prognosis in term of return to work.ConclusionsThis is the largest series of consecutive partial form of CRPS. The Budapest criteria are sufficient for the diagnosis in 88% of cases. As in complete form of CRPS1 of the hand, three phase bone scintigraphy should only be used in doubtful cases in the first six months of the illness. Partial form of CRPS1 of the hand is rare and its prevalence remains unknown. Long term prognosis (4 to 9 years) is poor in our series, 50% of patients didn’t returned to work.
Highlights
The partial form of the complex regional pain syndrome of the hand type 1 (CRPS 1), involving only to 3 fingers, is a rare condition first described in 1972
The aims of our study are to present this clinical form in a patient population with Complex regional pain syndrome type 1 (CRPS1) of the hand, to assess whether the criteria developed by Harden et al [17,18], the so called Budapest criteria, can be applied to this particular form and to define whether the various radiological examinations are still useful in order to propose an accurate diagnosis process for this rare entity
It should be kept in mind that there is still no consensus in the literature on the number of rays that define the partial form of Complex regional pain syndrome (CRPS)
Summary
The partial form of the complex regional pain syndrome of the hand type 1 (CRPS 1), involving only to 3 fingers, is a rare condition first described in 1972. The aim of the study is to define more precisely the diagnosis workup and the prognosis of this clinical entity. Complex regional pain syndrome type 1 (CRPS1) most commonly involves the extremities and the hand in particular [1,2]. The clinical form that involves the whole hand is the most familiar. Partial forms involving one to three fingers have been described. In 1977 and 1979, Lequesne et al [4,5] described a form of partial algodystrophy termed “radial”, which follows a Department for musculoskeletal rehabilitation, Clinique romande de réadaptation suvacare, 90 avenue du grand champsec, Sion 1951, Switzerland
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