Syndrome douloureux régional complexe de type I : clinique et examens complémentaires
Sophie Lahalle
Kinésithér Scient 2014,0552:05-09 - 10/03/2014
La clinique du syndrome douloureux régional complexe est le principal élément diagnostique. Classiquement, on distingue la séquence d'une phase chaude oedémateuse au cours de laquelle la douleur prédomine, puis d'une phase froide au cours de laquelle la raideur est au premier plan. Bien souvent, les patients ne répondent pas à ce schéma et la tendance est actuellement à distinguer des sous-groupes de malades dont la présentation principale correspond à l'une ou l'autre des phases. Les examens complémentaires, radiographie, scintigraphie osseuse et IRM, s'ils sont décevants en sensibilité et en précocité, permettent d'éliminer les diagnostics alternatifs particulièrement lors que l'algodystrophie complique un geste médical ou chirurgical.
Diagnosis of complex regional pain syndrome is mostly based on the patient's clinical presentation. Classically, we distinguish between the « hot » stage in which oedema and pain is predominant and the cold stage where sti_ ness is the main problem. Patients do not necessarily follow this pattern and there are often subgroups of patients which _ t predominantly into one of the 2 stages. Complementary investigations such as X-rays, scintigraphy and MRI have limited sensitivity but they are helpful in eliminating alternative diagnoses especially when CRPS complicates a medical or surgical treatment.
Diagnosis of complex regional pain syndrome is mostly based on the patient's clinical presentation. Classically, we distinguish between the « hot » stage in which oedema and pain is predominant and the cold stage where sti_ ness is the main problem. Patients do not necessarily follow this pattern and there are often subgroups of patients which _ t predominantly into one of the 2 stages. Complementary investigations such as X-rays, scintigraphy and MRI have limited sensitivity but they are helpful in eliminating alternative diagnoses especially when CRPS complicates a medical or surgical treatment.