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1.
Rev. chil. reumatol ; 34(4): 145-154, 2018. tab
Article in Spanish | LILACS | ID: biblio-1254243

ABSTRACT

Dolor regional complejo se reconoce como una entidad caracterizada por dolor de distribución regional que es desproporcional al estímulo que lo provocó. Se diferencia en tipo 1 cuando no existe un daño neurológico orgánico y en tipo 2 cuando sí existe lesión neurológica de base. El diagnóstico y el tratamiento constituyen un verdadero reto. Es necesario un alto nivel de sospecha diagnóstica y la instauración de un oportuno tratamiento interdisciplinario.


Complex regional pain is a painful disorder without a known mechanism. Two different types are classified depending if there are or not a neurological structural damage. The diagnosis and treatment are real challenges to the interdisciplinary team that should identify and bring an effective treatment to the patients. Clinicians should be aware of this entity in order to prevent delay in diagnosis and provide an early and effective treatment.


Subject(s)
Humans , Male , Female , Child , Complex Regional Pain Syndromes/physiopathology , Complex Regional Pain Syndromes/diagnosis , Complex Regional Pain Syndromes/therapy , Complex Regional Pain Syndromes/epidemiology , Diagnosis, Differential
2.
Rev. chil. neurocir ; 43(1): 59-68, July 2017. ilus, tab
Article in English | LILACS | ID: biblio-869780

ABSTRACT

Antecedentes: Los autores presentan una revisión crítica sobre el cuadro clínico, el diagnóstico, clasificación y tratamientodel síndrome de dolor regional complejo, discutiendo todos los métodos de tratamiento y haciendo hincapié en que la reabilitación debe ser empleada con el fin de obtener un mejor resultado. Aspecto psicológico debe ser discutido en el tratamiento y también se anima equipo multidisciplinario para participar en él.


Background: The authors presented a critical review about the clinical picture, diagnosis, classification and treatment ofcomplex regional pain syndrome, discussing all methods of treatment and emphasizing that the reabiltation must be employed in order to obtain a better result. Psychological aspect must be involved in the treatment and also multidisciplinary team is encouraged to take part on it.


Subject(s)
Humans , Causalgia , Chronic Pain , Pain Management/methods , Reflex Sympathetic Dystrophy , Complex Regional Pain Syndromes/classification , Complex Regional Pain Syndromes/diagnosis , Complex Regional Pain Syndromes/physiopathology , Complex Regional Pain Syndromes/psychology , Wounds and Injuries/complications , Movement Disorders , Stress, Psychological , Trauma, Nervous System
3.
Dolor ; 23(61): 36-44, jul.2013. tab, ilus, graf
Article in Spanish | LILACS | ID: lil-779251

ABSTRACT

El Síndrome de Dolor Regional Complejo (SDRC) es una enfermedad crónica, que se caracteriza por dolor y alteraciones sensitivas, motoras y autonómicas, a menudo sigue a trauma de un miembro, su curso es variable y, tanto su fisiopatología como el tratamiento, no están claramente establecidos. El objetivo de esta revisión es presentar una actualización de los aspectos generales de la enfermedad y mostrar parte de la evidencia existente en relación a las alternativas terapéuticas de la misma, tanto las conservadoras como las intervencionales. Es importante tener en consideración algunos puntos que limitan el objetivo de obtención de evidencia de buena calidad para el tratamiento de este síndrome. Lo primero es que el diagnóstico es clínico y los criterios para realizarlo han variado en el tiempo. Segundo, es la ausencia de criterios estandarizados para medir los resultados al tratamiento. Y, por último, ya que se trata de un síndrome crónico cuya manifestación principal es el dolor, existe respuesta a placebo...


The Regional Pain Syndrome Complex (CRPS ) is a chronic disease, which is characterized by pain and sensory, motor and autonomic disturbances, often follows trauma, the course and the pathophysiology are variable. The aim of this review is to provide an update on the general aspects of the disease and show the evidence in relation to therapeutic alternatives...


Subject(s)
Humans , Complex Regional Pain Syndromes/diagnosis , Complex Regional Pain Syndromes/therapy , Causalgia/diagnosis , Causalgia/therapy , Diagnosis, Differential , Reflex Sympathetic Dystrophy/diagnosis , Reflex Sympathetic Dystrophy/therapy
4.
Rev. Méd. Clín. Condes ; 23(4): 433-444, jul. 2012. ilus, tab
Article in Spanish | LILACS | ID: biblio-1145258

ABSTRACT

Los Síndromes Dolorosos Regionales son muy frecuentes y de etiología múltiple. e debe distinguir si son de origen músculoesquelético o se trata de dolor referido a la zona dolorosa. Las pruebas de movilidad pasiva y activa permiten diferenciar el dolor articular del periarticular. Se debe descartar compromiso neurológico y la presencia de signos de enfermedad sistémica. En dolor de columna, es importante distinguir el origen mecánico del inflamatorio, cuyo enfrentamiento es muy diferente. El dolor mecánico es el más frecuente, generalmente autolimitado y no requiere estudios complementarios. En el hombro, lo más frecuente es la patología del manguito rotador, especialmente en mayores de 40 años, y el tratamiento principal incluye analgesia y fisioterapia precoz. En la rodilla, los trastornos periarticulares incluyen bursitis y tendinitis de distintas estructuras, y hay que considerar la osteonecrosis dentro del diagnóstico diferencial del dolor de rodilla del adulto mayor.


Regional pain syndromes are common and caused by multiple etiologies. We have to distinguish whether their origin is musculoskeletal or the pain is referred to the painful area. Passive and active mobility allows differentiate extra-articular joint pain from joint pain. It should be ruled out neurological involvement and signs of systemic disease. In back pain, it is important to distinguish mechanical pain from inflammatory pain, because the causes and approach are very different. Mechanical pain is the most common, usually self-limitted and requires no additional studies. Rotator cuff tendinitis is the most common cause of shoulder pain, especially in patients over 40 years old. Treatment includes analgesia and early physiotherapy. In the knee, extra-articular disorders include bursitis and tendinitis of different structures, and osteonecrosis must be considered in the differential diagnosis of knee pain in the elderly.


Subject(s)
Humans , Low Back Pain , Complex Regional Pain Syndromes/diagnosis , Complex Regional Pain Syndromes/epidemiology , Sciatica , Magnetic Resonance Spectroscopy , Neck Pain , Shoulder Pain , Radial Neuropathy
5.
Article in English | WPRIM | ID: wpr-159020

ABSTRACT

Complex regional pain syndrome affects the quality of life of the patient. The aim of this study was to investigate the epidemiological features of this syndrome and evaluate its effect on the patient's working life. We demonstrated that the disease has a male preponderance and is 3 times more likely to affect the lower extremities. In this study, 11 participants (20%) retained their employment, whereas 44 (80%) became unemployed. Mean age and pain score were lower in the employment group than in the unemployment group (29.1 +/- 16.8 yr vs 40.1 +/- 12.6 yr, P = 0.021, and 4.5 +/- 2.9 vs 7.0 +/- 2.0, P = 0.002, respectively). Subjects diagnosed within 8 months (P = 0.044), those who had achieved higher levels of education (P = 0.028), and those working in white-collar jobs (P = 0.011) had higher employment-retention rates. Therefore, patients must manage their jobs (lower physical demand and decrease the number of working hours) if they are to improve their occupational life. To achieve satisfactory outcomes and a high employment-retention rate, clinicians must be aware of the importance of an early diagnosis (within 8 months), appropriate treatment, and a reduction in the patient's pain score.


Subject(s)
Adolescent , Adult , Aged , Complex Regional Pain Syndromes/diagnosis , Demography , Employment , Female , Humans , Interviews as Topic , Logistic Models , Male , Middle Aged , Quality of Life , Republic of Korea/epidemiology , Severity of Illness Index , Work , Young Adult
6.
Article in English | WPRIM | ID: wpr-173904

ABSTRACT

This study evaluated the structure of complex regional pain syndrome (CRPS) population and suggested a weighted scoring system to balance on objective signs. One hundred sixty-eight consecutive patients were evaluated using the Budapest Research Criteria (BRC). By using multidimensional scaling and logistic regression analysis, we analyzed the degree of importance and relationships between objective findings. In addition, a receiver operating characteristic curve was constructed using a weighted score derived from the risk ratio as a diagnostic test. There were correlations between skin color change and edema, and between decreased range of motion and motor dysfunction when multidimensional scaling was applied. The trophic change was excluded by a logistic regression (95% CI; 0.80-11.850). The cutoff point based on weighted score derived from the risk ratios for determining CRPS was 7.88. At this point, the sensitivity, specificity, positive predictive value and negative predictive value were 75.0%, 95.3%, 96.3%, and 70.1%, respectively. We propose a weighted scoring system for the BRC using risk ratios of objective signs. Although a thorough systematic review would be required in the future, this study can contribute to reduction of the possible distortion of the feature of CRPS populations by the BRC.


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Complex Regional Pain Syndromes/diagnosis , Diagnosis, Differential , Female , Humans , Logistic Models , Male , Middle Aged , Odds Ratio , Predictive Value of Tests , ROC Curve , Risk Factors , Severity of Illness Index
8.
Rev. chil. reumatol ; 24(2): 104-110, 2008. tab
Article in Spanish | LILACS | ID: lil-504088

ABSTRACT

El síndrome de dolor regional complejo tipo 1 (SDRC) constituye un cuadro doloroso que puede manifestarse de varias formas clínicas y cuya patogenia permanece oscura. Habitualmente es desencadenado por un trauma o intervención quirúrgica, en que la intensidad de la injuria no se relaciona necesariamente con la severidad de la sintomatología. Se presenta como un dolor neuropático que no sigue una distribución anatómica y en la cual no se evidencia una lesión neurológica demostrable. Tiene un patrón caracterizado por dolor, trastornos autonómicos y posteriormente presenta una fase atrófica. En la mayoría de los casos su evolución es favorable, aunque en un paciente individual ésta puede ser imprevisible. Múltiples tratamientos han sido utilizados. Hasta la fecha no se cuenta con una terapia definitiva.


The complex regional pain syndrome type 1 (CRPS) is a painful disorder which can manifest as different clinical entities, and its pathogenesis remains unclear. It is usually a product of trauma or surgery, in which the intensity of the injury is not related with severity of the symptomatology. It manifests as a neuropathic pain and does not follow any anatomic distribution, nor does it present any absolute neurological injury. This affliction has its own pattern characterized by pain, autonomic disorders and posterior trophic stage. Generally, evolution is favorable though unpredictable in any given patient. Different treatments have been used, however at present there is no definitive treatment.


Subject(s)
Humans , Complex Regional Pain Syndromes/diagnosis , Complex Regional Pain Syndromes/physiopathology , Clinical Evolution , Diagnosis, Differential , Complex Regional Pain Syndromes/etiology , Complex Regional Pain Syndromes/therapy
9.
Article in English | WPRIM | ID: wpr-37044

ABSTRACT

Complex regional pain syndrome (CRPS) is a chronically painful and disabling disorder. However, no data are available even on the epidemiology of CRPS in Korea. This study was undertaken to retrospectively assess the epidemiologic characteristics of CRPS in 150 consecutive patients at a tertiary chronic pain center from March 2002 to February 2006. Information was obtained regarding patients' demographics, nature of injury, and treatment modalities. Seventy-one percent of patients had CRPS type I. The mean 11-point verbal numerical rating scale score at initial examinations and at the time of study were 8.0 and 5.7, respectively. Thirty-two percent of patients showed no change or increase in pain intensity during follow-up at our pain center. The mean duration of CRPS symptoms prior to our pain center evaluation and prior to the time of study were 27 months and 50 months, respectively. These patients had seen on average 5 different physicians before being referred to our center. This study shows that the majority of CRPS patients were referred to our center after more than 2 yr of symptoms. The clinical implication of such delayed transfer and strategies to avoid this problem are discussed.


Subject(s)
Adult , Complex Regional Pain Syndromes/diagnosis , Female , Humans , Korea , Male , Middle Aged , Pain/epidemiology , Pain Clinics , Pain Measurement/methods , Retrospective Studies , Time Factors , Wounds and Injuries/complications
10.
Medicina (B.Aires) ; 65(5): 425-428, 2005. ilus
Article in Spanish | LILACS | ID: lil-445761

ABSTRACT

Complex regional pain syndrome, reflex sympathetic dystrophy, regional, transient and migratory osteoporosis, are known as a spectrum of medical conditions that present with pain, edema, erythema, localized osteoporosis and sometimes sympathetic dysfunction. Many factors which are present in these conditions, such as clinical presentation, radiologic findings and a variety of still unclear physiopathologic mechanisms are correlated. We propose that all these conditions are different periods of the same pathology.


Síndrome doloroso regional complejo, distrofia simpática refleja, osteoporosis regional, transitoria, y migratriz, representan un espectro de alteraciones que se presentan con dolor, edema, eritema, osteoporosis localizada y en ocasiones disfunción simpática descripta en muchos sitios esqueléticos. Muchosfactores, tales como la forma de presentación clínica, los hallazgos radiológicos y la fisiopatología desconocida de estas enfermedades las correlacionan íntimamente. Proponemos entonces, mediante la presentación de uncaso clínico, que dichas entidades son estadios y presentaciones diferentes de una misma enfermedad.


Subject(s)
Adult , Humans , Male , Reflex Sympathetic Dystrophy/diagnosis , Foot Diseases/diagnosis , Hip , Osteoporosis/diagnosis , Femur Head , Diagnosis, Differential , Reflex Sympathetic Dystrophy , Foot Diseases , Osteoporosis , Hip , Complex Regional Pain Syndromes/diagnosis , Complex Regional Pain Syndromes
11.
Clín. méd. H.C.C ; 8(2): 70-75, mayo-ago. 2003. ilus
Article in Spanish | LILACS | ID: lil-411866

ABSTRACT

El Síndrome Regional Doloroso Complejo (SRDC) es una enfermedad crónica caracterizada por un dolor intenso acompañado de ardor, cambios de coloración de la piel, sudoración profusa, cambios inflamatorios locales,hiperestesia cutánea y alteraciones óseas. Este síndrome es un trastorno del sistema nervioso simpático que por razones aún desconocidas permanece hiperactivo. Aquí presentamos el caso de una mujer de 28 años de edad que sufrió una fractura en el pie derecho y desarrolló SDRC tipo I y el tratamiento que le fué aplicado


Subject(s)
Humans , Adult , Female , Medical Examination , Radiography , Complex Regional Pain Syndromes/diagnosis , Complex Regional Pain Syndromes/therapy , Internal Medicine , Venezuela
12.
Rev. bras. anestesiol ; 52(5): 618-627, set.-out. 2002. ilus
Article in Portuguese, English | LILACS | ID: lil-330691

ABSTRACT

Justificativa e objetivos - A Síndrome Dolorosa Complexa Regional (SDCR), assim denominada a partir de 1994 pelo Consenso da Associação Internacional para o Estudo da Dor (AIED) e anteriormente denominada de várias formas, tais como Distrofia Simpático Reflexa, Causalgia, Algodistrofia ou Atrofia de Sudeck, é uma doença cuja compreensão dos limites clínicos, fisiopatologia e implicações de patogenia ainda é pobre. Disto resulta a enorme insatisfação não só para os pacientes como para os profissionais da saúde quanto aos métodos terapêuticos atualmente disponíveis. O objetivo deste trabalho é rever a literatura e atualizar um conjunto de informações com o intuito da melhor compreensão desta importante síndrome dolorosa. Conteúdo - Este é um trabalho de revisão da literatura nos diversos aspectos da SDCR, com ênfase em suas causas, definição e taxonomia, fisiopatologia, características clínicas, testes diagnósticos e propostas de tratamentos mais recentes. Conclusões - Poucos são os estudos controlados adequadamente, encobertos e aleatórios, publicados com grandes amostras, havendo muitas dúvidas sobre esta doença. Desta forma, ainda há enorme empirismo na sua terapêutica, e os resultados obtidos são insatisfatórios


Subject(s)
Humans , Complex Regional Pain Syndromes/diagnosis , Complex Regional Pain Syndromes/physiopathology , Complex Regional Pain Syndromes/therapy
13.
Bol. Hosp. San Juan de Dios ; 48(6): 396-400, nov.-dic. 2001.
Article in Spanish | LILACS | ID: lil-310210

ABSTRACT

Los síndromes neurovasculares son un conjunto de cuadros clínicos de los miembros, caracterizados por dolor quemante e hiperestesia cutánea; alteraciones tróficas de la piel, fanerios y tejidos subyacentes; de evolución crónica continua o intermitente, que son debida a alteraciones vasomotoras y neurovegetativas regionales desencadenantes por diversos factores entre los que destacan los traumatismos; las compresiones; los fenómenos isquémicos; algunas intervenciones quirúrgicas. Entre estos síndromes, denominados también algodistrofia figuran la distrofia simpática refleja; la causalgia, el síndrome del opérculo torácico o cintura escapular; el síndrome del túnel carpiano y tarsiano; el síndrome hombro-mano de Südeck, etc. Estos cuadros no crónicos, su tratamiento es complejo; producen invalidez y alteraciones tróficas muchas veces irreversibles


Subject(s)
Humans , Complex Regional Pain Syndromes/diagnosis , Causalgia , Reflex Sympathetic Dystrophy/diagnosis , Carpal Tunnel Syndrome/diagnosis , Tarsal Tunnel Syndrome/diagnosis
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