Complex Regional Pain Syndromes in The Rheumatology Clinic

The differential diagnosis of complex regional pain syndrome (CRPS) type I is wide and includes almost any other cause of regional pain (Table 1). There may be a history of trauma, including surgery, preceding the onset of symptoms, and other causes of localized pain include fracture and ligamentous injury. In view of this, fracture should be considered as a differential diagnosis. However, the two may coexist, usually with CRPS type I developing as a complication of fracture but, if a fracture is present, this must be diagnosed so that correct management may be instituted. As CRPS type I often involves a joint, the diagnosis of septic arthritis and other causes of a monoarthritis should be considered. Vascular disease may also present as regional pain associated with colour change and, as a consequence, some patients with CRPS type I present initially to vascular surgeons.