Complex regional pain syndrome - type 1

Case contributed by Bálint Botz
Diagnosis almost certain

Presentation

Sustained a fall resulting in right distal radius and ulnar styloid process fractures six weeks earlier, which was surgically stabilized. Ongoing pain and limited movement.

Patient Data

Age: 40 years
Gender: Female

Control XR 6 wk post injury

x-ray

Volar locking plate in situ. Diffuse patchy, largely subperiosteal osteopenia can be observed (see key image), primarily affecting the carpal bones. These features are highly suggestive of CRPS. 

Initial x-ray for comparison

x-ray

Apart from the impacted Colles fracture, and the fracture of the ulnary styloid process, the bones displayed initially a normal structure. 

Case Discussion

Typical presentation of type 1 (as no underlying nerve lesion was identified) CRPS that developed after a fracture. 

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