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Is there a correlation between symptoms and bone scintigraphic findings in patients with complex regional pain syndrome?

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Abstract

Background

Complex regional pain syndrome (CRPS) is characterized by pain in combination with sensory, vasomotor, sudomotor, trophic and motor abnormalities. The diagnosis of CRPS is based primarily on clinical criteria and the presence of distinct signs and symptoms. The role of bone scintigraphy in the diagnosis of these patients has been limited by its variable sensitivity. In this study, we aim to look if the presence of specific symptoms or symptom subgroups in patients with clinically diagnosed CRPS correlates with scintigraphic findings in bone scan.

Materials and methods

We retrospectively reviewed clinical records of patients referred for bone scintigraphy with the clinical diagnosis of CRPS during the period December 2006 until February 2011. Patients were classified into 4 distinct subgroups according to the presence of specific symptoms namely sensory subgroup, sudomotor and/or edema subgroup, vasomotor subgroup and finally motor and/or trophic changes subgroup. We looked specifically for the correlation between these specific symptoms and scintigraphic bone findings.

Results

37 patients were referred for bone scintigraphy with the clinical diagnosis of CRPS and were enrolled in the study. The presence of vasomotor symptoms and (motor and/or trophic changes) was significantly higher in patients with positive bone scintigraphy (P value 0.0133, 0.018 respectively). There was no other statistically significant correlation between the presence of specific symptoms or symptom subgroups on one hand and the result of bone scintigraphy on the other hand.

Conclusions

The probability of positive bone scintigraphy increased significantly in patients with vasomotor symptoms and in patients with motor and/or trophic changes. This may contribute to the reported variability of the diagnostic performance of bone scintigraphy in CRPS patients.

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Acknowledgments

We would like to thank Dr. Muhannad Akash for his work in statistical analysis. We would also thank Mr. Omari Zeyad and Mr. Rizeq Attish for their technical support.

Conflict of interest

No potential conflicts of interest were disclosed. This retrospective study did not receive any funding.

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Authors and Affiliations

  1. Nuclear Medicine Section, Radiology and Nuclear Medicine Department, Faculty of Medicine, Jordan University Hospital, University of Jordan, Queen Rania Street, Al-Jubeiha, P.O.Box 13046, 11942, Amman, Jordan

    Abedallatif AlSharif, Rasha F. Sheikh-Ali & Malik E. Juweid

  2. Orthopedics Section, Special Surgery Department, Faculty of Medicine, University of Jordan, Amman, Jordan

    Alaa Y. Akel, Jihad M. Ajlouni, Ameer S. Abdulsahib, Fadi A. AlHadidi & Shaher T. ElHadidy

  3. Department of Physical Therapy, Faculty of Rehabilitation Sciences, University of Jordan, Amman, Jordan

    Ziad M. Hawamdeh

Authors
  1. Abedallatif AlSharif
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  2. Alaa Y. Akel
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  3. Rasha F. Sheikh-Ali
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  4. Malik E. Juweid
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  5. Ziad M. Hawamdeh
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  6. Jihad M. Ajlouni
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  7. Ameer S. Abdulsahib
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  8. Fadi A. AlHadidi
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  9. Shaher T. ElHadidy
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Correspondence to Abedallatif AlSharif.

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AlSharif, A., Akel, A.Y., Sheikh-Ali, R.F. et al. Is there a correlation between symptoms and bone scintigraphic findings in patients with complex regional pain syndrome?. Ann Nucl Med 26, 665–669 (2012). https://doi.org/10.1007/s12149-012-0623-2

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  • DOI: https://doi.org/10.1007/s12149-012-0623-2

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