CRPS Flashcards

1
Q

what is the pathogenesis of CRPS? (3)

A

classic inflammation
neurogenic inflammation
maladaptive changes in pain perception at CNS

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2
Q

what is the clinical presentation of a patient with CRPS? (3)

A

pain/hyperalgesia
burning/stinging/tearing deep inside the limb
allodynia

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3
Q

a patient presents with pain, erythema, and swelling in a limb about 4-6 weeks after an inciting event. Dx?

A

stage 1 CRPS

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4
Q

what are the 4 most common inciting event of CRPS?

A

fractures
crush injuries
sprains
surgery

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5
Q

where does CRPS most commonly begin?

A

upper limb

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6
Q

progression of edema in the soft tissue, thickening of skin and articular soft tissues, muscular wasting, and development of brawny skin

A

stage 2 CRPS

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7
Q

how long does stage 2 of CRPS typically last?

A

3-6 months

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8
Q

limited movement, shoulder-hand syndrome, contractures of digits, waxy trophic skin changes, bone demineralization, and brittle/ridged nails.

A

stage 3 CRPS

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9
Q

capsular retraction producing a frozen shoulder

A

shoulder-hand syndrome

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10
Q

how is CRPS diagnosed?

A

clinical
no gold standard

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11
Q

what diagnostic can be used to detect alterations in bone metabolism in patients with CRPS who have active bone resorption?

A

bone scan

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12
Q

what diagnostic can be used to find patchy osteoporosis?

A

plain film

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13
Q

what is the management for CRPS? (2)

A

vitamin C
early mobilization after limb injury

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14
Q

what pharmacotherapy can be used for CRPS? (2)

A

ibuprofen / naproxen
amitriptyline / nortripytline

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15
Q

what meds can be used for neuropathic pain? (2)

A

gabapentin
lidocaine cream / topical capsaicin

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16
Q

what 2 meds can be used to decrease bone resorption?

A

bisphosphonates
calcitonin

17
Q

what medication can be used in CRPS if the patient does not get any relief from other medications?

A

glucocorticoids - prednisone

18
Q

what should be done if a patient with CRPS has an unknown MOA of analgesia?

A

spinal cord stimulation

19
Q

what can cause recurrence of CRPS? (3)

A

cold exposure
new surgery
emotional trauma

20
Q

when can elective surgery for CRPS be done?

A

only when previous episodes have resolved