Ultrasound Appearance of Forearm Muscles in 18 Patients With Complex Regional Pain Syndrome 1 of the Upper Extremity

Objective:  To explore the potential diagnostic utility of musculoskeletal ultrasonography (USG) changes in complex regional pain syndrome type 1 (CRPS‐1) of the upper extremity. Methods:  With informed consent, 18 consecutive patients referred to our institution with CRPS‐1 of the upper limb were e...

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Bibliographic Details
Published in:Pain practice 2013-01, Vol.13 (1), p.76-88
Main Authors: Vas, Lakshmi Champak, Pai, Renuka, Radhakrishnan, Mahesh
Format: Article
Language:English
Subjects:
Adult
Aged
complex regional pain syndrome type 1
Female
Forearm
Forearm - diagnostic imaging
Forearm - pathology
Humans
Male
Middle Aged
motor impairment
muscle morphology
Muscle, Skeletal - diagnostic imaging
musculoskeletal ultrasonography
Pain Measurement
Reflex Sympathetic Dystrophy
Ultrasonography, Doppler
Upper Extremity - pathology
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Summary:Objective:  To explore the potential diagnostic utility of musculoskeletal ultrasonography (USG) changes in complex regional pain syndrome type 1 (CRPS‐1) of the upper extremity. Methods:  With informed consent, 18 consecutive patients referred to our institution with CRPS‐1 of the upper limb were examined with ultrasound scanning of both upper limbs. Qualitative comparison of the scan of the forearm muscles of the affected side with the unaffected side was made. Results:  The muscles affected by CRPS‐1 demonstrated increased echogenecity. The outlines of the muscles were either indistinct or completely obliterated. A group of several muscles appeared like one homogenous, hyperechoic mass, with loss of normal architecture. Compared with the unaffected side, the muscle thickness on the CRPS‐1 side measured by calipers on ultrasound was reduced irrespective of the duration of disability or disuse of the hand. The flexors and extensor muscles of the forearm were maximally affected. Conclusion:  Ultrasonography provides useful anatomical information, regarding structure, kinesiology, and gross pathological changes of muscle, that may prove useful in understanding the motor impairment associated with CRPS‐1. USG shows promise as a cost‐effective bedside tool for the diagnosis of CRPS‐1 and in guiding physical therapy.
ISSN:1530-7085
1533-2500
DOI:10.1111/j.1533-2500.2012.00539.x