Usefulness of bone scintigraphy for the diagnosis of Complex Regional Pain Syndrome 1: A systematic review and Bayesian meta-analysis.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Competing Interests: The authors have declared that no competing interests exist. 15. Neurol India. 2022 May-Jun;70(3):1119-1124. doi: 10.4103/0028-3886.349675. Osteo-Cutaneous Trophic Changes in Complex Regional Pain Syndrome and their Reversal with Steroids. Pradhan S(1), Bansal R(1), Das A(1), Pardasani V(2), Malhotra HS(3), Kushwaha S(2), Mishra VN(1). Author information: (1)Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India. (2)Department of Neurology, Institute of Human Behavior and Allied Sciences, Delhi, India. (3)Department of Neurology, King George's Medical College, Lucknow, Uttar Pradesh, India. BACKGROUND: Complex regional pain syndrome (CRPS) is a chronic pain condition characterized by autonomic and inflammatory features. There is paucity of data regarding sustained benefits of any treatment modality. We aimed to document the effect of steroids in CRPS on long-term basis. MATERIALS AND METHODS: We came across five patients of CRPS in Out Patient clinics of super-speciality Institutes in North India. All five cases fulfilled the Budapest criteria for the diagnosis of CRPS. All of them received prednisolone and were prospectively followed up for 2 years. Treatment outcome was carefully recorded in all affected modalities. RESULTS: All five cases were found to have excruciating neuropathic pain in defined regions along with cutaneous manifestations. Osseous changes in the form of surface erosion of underlying bones in four cases and marked marrow edema leading to considerable increase in bone thickness in one case were noted. All these features improved considerably following steroid therapy. Bone marrow edema and bone resorption showed improvement on serial imaging. CONCLUSION: Apart from pain relief, steroids therapy is capable of reversing the osteo-cutaneous autonomic changes of CRPS type I. DOI: 10.4103/0028-3886.349675