Complex Regional Pain Syndrome

Debashish Mishra, Arghya Chattopadhyay, Anwin Joseph Kavanal, Rajender Kumar, Shefali K. Sharma
2021 Mediterranean Journal of Rheumatology  
A 63-year-old woman presented with history of severe diffuse pain (even on touch) and swelling over right forearm and hand for 6 weeks. On inquiry, she gives history of past herpetic lesions over same side 4 months back. On examination, there was diffuse swelling, tenderness and warmth over right hand and forearm, along with increased sweating and loss of hair ( Figure 1A) . Radiograph showed patchy osteopenia around right wrist and small joints of hand ( Figure 1B) . Triple phase skeletal
more » ... igraphy showed increased flow, perfusion and osteoblastic activity in right shoulder, elbow, wrist, and small joints of hand suggestive of complex regional pain syndrome (CRPS) (Figure 1 C-F) . Her inflammatory markers (erythrocyte sedimentation rate and C-reactive protein) were normal, and rheumatoid factor, anti-nuclear antibody, and viral serologies (Human immunodeficiency virus, hepatitis B and C) were negative. Based on clinical and imaging findings, a diagnosis of CRPS triggered by herpes zoster infection was made.
doi:10.31138/mjr.32.2.174 fatcat:chrdtx5e5jauhhoayskzmh5axq