[Complex regional pain syndrome].

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Abstract

[Indexed for MEDLINE] 20. Eur J Radiol. 2020 Aug;129:109044. doi: 10.1016/j.ejrad.2020.109044. Epub 2020 May 6. MRI of complex regional pain syndrome in the foot. Agten CA(1), Kobe A(2), Barnaure I(3), Galley J(3), Pfirrmann CW(3), Brunner F(4). Author information: (1)University Hospital Balgrist, Radiology, Forchstrasse 340, 8008 Zurich, Switzerland; University of Zurich, Faculty of Medicine, Pestalozzistrasse 3, 8091 Zurich Switzerland. Electronic address: Christoph.agten@balgrist.ch. (2)University Hospital Zurich, Radiology, Rämistrasse 100, 8091 Zurich, Switzerland; University of Zurich, Faculty of Medicine, Pestalozzistrasse 3, 8091 Zurich Switzerland. (3)University Hospital Balgrist, Radiology, Forchstrasse 340, 8008 Zurich, Switzerland; University of Zurich, Faculty of Medicine, Pestalozzistrasse 3, 8091 Zurich Switzerland. (4)University Hospital Balgrist, Rheumatology, Forchstrasse 340, 8008 Zurich, Switzerland; University of Zurich, Faculty of Medicine, Pestalozzistrasse 3, 8091 Zurich Switzerland. PURPOSE: To evaluate the diagnostic potential of MRI in patients with suspected CRPS (complex regional pain syndrome). METHOD: A retrospective health-record search was conducted for patients with suspected CRPS (foot). Fifty patients with initially suspected CRPS were included (37 females (51 ± 13 years) and 13 males (44 ± 15 years)). All patients underwent MRI. Two radiologists assessed skin, bone, and soft tissue parameters on MRI. The final diagnosis was CRPS (Gold standard: Budapest criteria) or non-CRPS. MRI parameters were compared between CRPS patients and non-CRPS patients. RESULTS: CRPS was diagnosed in 22/50(44 %) patients. Skin thickness (1.9 ± 0.5 mm vs. 1.7 ± 0.3 mm, p = 0.399), enhancement, and subcutaneous edema showed no differences between CRPS and non-CRPS patients. Bone marrow edema presence and pattern were not different between groups. Up to 50 % of CRPS patients showed no bone marrow edema. Subcortical enhancement and periosteal enhancement were not different between groups. For reader 1, muscle edema score was higher in the non-CRPS group compared to the CRPS group (0.1 ± 0.2 vs. 0.6 ± 1.0, p = 0.008), but not different for reader 2 (0.1 ± 0.5 vs. 0.2 ± 0.8, p = 0.819). Perfusion pattern was more extensive in non-CRPS patients for reader 1 (p = 0.048), but not for reader 2 (p = 0.157). Joint effusions showed no difference between groups. CONCLUSIONS: MRI cannot distinguish between CRPS and non-CRPS patients. The role of MR imaging in patients with suspected CRPS is to exclude alternative diagnoses that would better explain patients' symptoms. Copyright © 2020. Published by Elsevier B.V. DOI: 10.1016/j.ejrad.2020.109044