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The aim of the study is to investigate the correlation between increased bone metabolism in the 3 phase bone scintigraphy (TPBS) and decreased pressure pain thresholds in patients with complex regional pain syndrome (CRPS) of the upper limb and a non-CRPS-group. The investigators assume that there will be a significant correlation between the investigated values in the CRPS-group whereas the non-CRPS-group shows no significant correlation.
Pressure pain of the distal hand joints is a predominant symptom of CRPS. But so far, the diagnostic value of pressure pain in the diagnosis of CRPS has not been investigated. We compared the pressure pain thresholds of the carpus, metacarpophalangeal and proximal interphalangeal joints to a region of interest-based (ROI) analysis of a TBPS in patients with CRPS and patients with limb pain of other origin (non-CRPS-group).Additionally, the PPTs were established for a healthy control group to get reference data.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients with CRPS | 18 patients with unilateral CPRS of the upper limb were included to the study |
| |
| Patients with limb pain of other origin | 17 patients with unilateral upper limb pain of other origin served as control group |
| |
| Healthy subjects | 18 healthy subjects were included to establish reference data for the pressure pain thresholds |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Pressure Pain measurement | Procedure | The pressure pain thresholds were established using a manual pressure algometer. The investigated joints were the carpus, the metacarpophalangeal and the proximal interphalangeal joints |
| Measure | Description | Time Frame |
|---|---|---|
| Decrease of the pressure pain thresholds of the distal hand joints | The pressure pain thresholds (PPT) were mesured for the carpus, metacarpophalangeal and proximal interphalangeal joints of both hands. The mean of three determined measurements of each joint was taken as the final value. Subseqently the PPT were compared to the results of the 3 phase bone scintigraphy and the reference data of the healthy subjects. | half an hour |
| Measure | Description | Time Frame |
|---|---|---|
| Increased bone metabolism in the 3 phase bone scintigraphy | All Patients with CRPS and limb pain of other origin underwented a 3 phase bone scitigraphy to investigate a possible increased bone metabolism. Phase one and two were recorded within the first five minutes after injection of approximately 500-700 MBq 99mTechnetium-labeled methylene diphosphonate. The third phase was obtained two to three hours after injection. |
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Inclusion Criteria:
every participant:
Patients with CRPS:
Control group:
Healthy subjects:
Exclusion Criteria:
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The study sample consists of three groups:
All patients were recruited from the Department of Pain medicine and the Department of nuclear medicine of the University Hospital Bergmannsheil
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| Name | Affiliation | Role |
|---|---|---|
| Christoph Maier, Prof. Dr. | Head of the pain clinic of the Bergmannsheil University Hospital | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Bergmannsheil, department for pain management | Bochum | North Rhine-Westphalia | 44789 | Germany |
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|
| 3 hours |
| ID | Term |
|---|---|
| D012019 | Reflex Sympathetic Dystrophy |
| ID | Term |
|---|---|
| D020918 | Complex Regional Pain Syndromes |
| D001342 | Autonomic Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
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