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Complex Regional Pain Syndrome Diagnostic Tests
Radiographs (x-rays)
Plain radiographs (x-rays) show the parts of the patient that absorb or block the rays. This captured image can be collected on photosensitive film, digital imaging plate, or fluoroscope (2). The essential radiograph is developed film exposed to x-ray or gamma ray.
In a patient with CRPS, x-rays show the status of mineralization in the bones of the affected side in comparison to the opposite side. Since 1902, with Dr. Paul Sudeck’s description of radiographic changes in patients with CRPS, a conventional bilateral x-ray of the hand has been standard for CRPS diagnosis (3). During the first stage of CRPS (0-3 months), x-rays usually look normal, while in later stages (3-12 months) osteopenia appears on the x-rays (4). Positive findings can be observed in chronic stages, but also can be related to disuse atrophy (5). According to a recent study in Germany, specificity is high for x-rays and "plain radiographs facilitate the diagnosis [of CRPS] as soon as bony changes develop" (6).
J. H. B. Geertzen, MD, PhD, professor and rehabilitation specialist at Groningen University Medical Center in the Netherlands reported in a personal communication to RSDSA that he “always used x-rays to look for missed fractures.”
Because this method is less invasive than some of the other diagnostic tests mentioned, it is often used as a preliminary test to view bone mineralization status and track it through the disease process. Demineralization with disuse and loss of function of the CRPS-affected area increases with time (3).
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Updated December 20, 2007 |
