Arthrose et appareil locomoteur
Le 14/10/2021 de 14:30 à 16:00
Typologie du SDRC détecté précocement en consultation spécialisée
Mihailo Obrenovic (Sion, Suisse), Michel Konzelmann (Sion, Suisse), Bertrand Léger (Sion, Suisse), Virginie Crittin (Sion, Suisse), François Luthi (Sion, Suisse)
Objective : CRPS is rare and most often occurs after orthopedic trauma. Diagnosis is only based on clinical findings, leading to delay, misdiagnosis and poor prognosis. In the literature, a large part of knowledge is derived from retrospective studies of longstanding CRPS. Our objective is to constitute a cohort of early CRPS with a prospective follow-up.
Material / Patients and Methods : Prospective study with cross-sectional data. Collaboration with trauma and hand surgery departments. Priority access to the PRM consultation for suspected early CRPS (< 6 months). Diagnosis according to the Budapest criteria. Neuropathic components of pain with DN4 questionnaire.
Results : Since April 2019, 60 patients were included (female 72%, mean age 51 years, mean pain 4.7/10). Initial trauma to diagnosis interval was 146 days (4.8 months), onset of symptoms to diagnosis interval was 96.5 days (3.2 months). 70% of patients had upper limb involvement and 30% had lower limb involvement, the vast majority being distal (93%). 7% were bifocal, mostly shoulder-arm syndrome. More than 85% of patients reported vasomotor disorders, sensory disorders, oedema, as well as joint stiffness and weakness. The mean DN4 was 4.4/10. The clinical signs found were most often: reduced joint mobility (93%), joint movement allodynia (78%), and oedema (65%).
Discussion - Conclusion : Analysis of symptoms and signs of early CRPS evaluated most often movement allodynia, joint stiffness and oedema. The Budapest criteria are reliable for detection and diagnosis at 3.2 months from the onset of symptoms and at 4.8 months from the initial trauma.
Keywords : CRPS, SDRC, Algodystrophy, Sudeck, Pain, Budapest, DN4