Complex Regional Pain Syndrome Type I Following Non-Orthopedic Surgery: Case Report and Narrative Review
Complex regional pain syndrome type I (CRPS I)—or algodystrophy—is a rare disease that usually occurs after a traumatic event. It is characterized by typical clinical findings such as severe and disabling pain disproportionate to the injury, functional limitations, as well as sensory and vasomotor a...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-09-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/11/9/1596 |
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| author | Antimo Moretti Francesca Gimigliano Marco Paoletta Matteo Bertone Sara Liguori Giuseppe Toro Giovanni Iolascon |
| author_facet | Antimo Moretti Francesca Gimigliano Marco Paoletta Matteo Bertone Sara Liguori Giuseppe Toro Giovanni Iolascon |
| author_sort | Antimo Moretti |
| collection | DOAJ |
| description | Complex regional pain syndrome type I (CRPS I)—or algodystrophy—is a rare disease that usually occurs after a traumatic event. It is characterized by typical clinical findings such as severe and disabling pain disproportionate to the injury, functional limitations, as well as sensory and vasomotor alterations. However, some people do not report any injury associated with algodystrophy onset in personal history. We describe the management of an unusual case of CRPS I which occurred during the long-term follow-up of percutaneous transluminal coronary angioplasty (PTCA) and performed a narrative review of algodystrophy in non-orthopedic surgery. A clinical case of a 44-year-old man with a spontaneous onset of CRPS I of the right ankle is presented. He did not refer to history of any memorable significant trigger event. Approximately 5 months before the onset of clinical manifestations, he received a PTCA via the right femoral approach. We suppose an association between CRPS and this procedure and propose a possible pathophysiologic mechanism. The patient was treated with intramuscular neridronate, which resulted in significant pain relief and improved his quality of life. A comprehensive clinical and instrumental evaluation in patients with CRPS is challenging but mandatory for a correct diagnosis. An extensive analysis of patient history is important for identifying any potential trigger event, including non-orthopedic procedures. Bone scan could have a pivotal role for improving diagnostic sensitivity and specificity in CRPS I. Neridronate was a safe and effective therapeutic approach for this patient, confirming the results of the high-quality evidence available. |
| first_indexed | 2024-03-10T07:46:33Z |
| format | Article |
| id | doaj.art-88ca8cdef1fa4be6882ed1fe22451959 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T07:46:33Z |
| publishDate | 2021-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-88ca8cdef1fa4be6882ed1fe224519592023-11-22T12:39:25ZengMDPI AGDiagnostics2075-44182021-09-01119159610.3390/diagnostics11091596Complex Regional Pain Syndrome Type I Following Non-Orthopedic Surgery: Case Report and Narrative ReviewAntimo Moretti0Francesca Gimigliano1Marco Paoletta2Matteo Bertone3Sara Liguori4Giuseppe Toro5Giovanni Iolascon6Department of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, ItalyDepartment of Mental and Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, ItalyDepartment of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, ItalyDepartment of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, ItalyDepartment of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, ItalyDepartment of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, ItalyDepartment of Medical and Surgical Specialties and Dentistry, University of Campania “Luigi Vanvitelli”, 80138 Naples, ItalyComplex regional pain syndrome type I (CRPS I)—or algodystrophy—is a rare disease that usually occurs after a traumatic event. It is characterized by typical clinical findings such as severe and disabling pain disproportionate to the injury, functional limitations, as well as sensory and vasomotor alterations. However, some people do not report any injury associated with algodystrophy onset in personal history. We describe the management of an unusual case of CRPS I which occurred during the long-term follow-up of percutaneous transluminal coronary angioplasty (PTCA) and performed a narrative review of algodystrophy in non-orthopedic surgery. A clinical case of a 44-year-old man with a spontaneous onset of CRPS I of the right ankle is presented. He did not refer to history of any memorable significant trigger event. Approximately 5 months before the onset of clinical manifestations, he received a PTCA via the right femoral approach. We suppose an association between CRPS and this procedure and propose a possible pathophysiologic mechanism. The patient was treated with intramuscular neridronate, which resulted in significant pain relief and improved his quality of life. A comprehensive clinical and instrumental evaluation in patients with CRPS is challenging but mandatory for a correct diagnosis. An extensive analysis of patient history is important for identifying any potential trigger event, including non-orthopedic procedures. Bone scan could have a pivotal role for improving diagnostic sensitivity and specificity in CRPS I. Neridronate was a safe and effective therapeutic approach for this patient, confirming the results of the high-quality evidence available.https://www.mdpi.com/2075-4418/11/9/1596complex regional pain syndromesreflex sympathetic dystrophyneridronatediphosphonatesangioplastyballoon |
| spellingShingle | Antimo Moretti Francesca Gimigliano Marco Paoletta Matteo Bertone Sara Liguori Giuseppe Toro Giovanni Iolascon Complex Regional Pain Syndrome Type I Following Non-Orthopedic Surgery: Case Report and Narrative Review Diagnostics complex regional pain syndromes reflex sympathetic dystrophy neridronate diphosphonates angioplasty balloon |
| title | Complex Regional Pain Syndrome Type I Following Non-Orthopedic Surgery: Case Report and Narrative Review |
| title_full | Complex Regional Pain Syndrome Type I Following Non-Orthopedic Surgery: Case Report and Narrative Review |
| title_fullStr | Complex Regional Pain Syndrome Type I Following Non-Orthopedic Surgery: Case Report and Narrative Review |
| title_full_unstemmed | Complex Regional Pain Syndrome Type I Following Non-Orthopedic Surgery: Case Report and Narrative Review |
| title_short | Complex Regional Pain Syndrome Type I Following Non-Orthopedic Surgery: Case Report and Narrative Review |
| title_sort | complex regional pain syndrome type i following non orthopedic surgery case report and narrative review |
| topic | complex regional pain syndromes reflex sympathetic dystrophy neridronate diphosphonates angioplasty balloon |
| url | https://www.mdpi.com/2075-4418/11/9/1596 |
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