Class notes
Klinische Les Chronische Pijn (deeltenamen 1)
- Course
- Institution
Aantekeningen bij de klinische les over chronische pijn (deeltentamen 1)
[Show more]
Seller
Follow
MdG
Reviews received
Content preview
Klinische Les 1 – Complex Regional PainSyndrome
Hiervoor genoemd: Reflex Sympathetic Dystrophy Syndrome (sympathische
reflexdystrofie)
Deel I: Dr. Robert Perez
Symptomen
Er zijn vele verschillende fenotypes, met allemaal net andere symptomen. Dit
maakt herkenning vaak moeilijk.
Definitie CRPS
CRPS is a syndrome characterized by a continuing (spontaneous and/or evoked)
regional pain;
- Pain is a seemingly disproportionate in time or degree to the usual course
of pain after trauma or other lesion
- Pain is a regional (not in a specific nerve territory or dermatome) and
usually has a distal predominance of abnormal sensory, motor, sudomotor,
vasomotor edema, and/or trophic findings.
- The syndrome shows variable progression over time.
Two types of CRPS
- Type I usually develops after any type of trauma, especially fracture, soft
tissue lesion;
, - Type II occurs after major nerve damage.
Population
Piekleeftijd: rond de 65 jaar (populatie, IPCI), rond de 40 (in de kliniek, TREND)
Epidemiologie
- 22/100.000 persoonsjaren (2700 nieuwe per jaar)
- 1/80 mensen ontwikkeld CRPS
- Man:Vrouw = 1:4
- Weefselschade bij >80%
o Trauma (fracturen, operaties, etc.)
o Non-trauma (trombose, myocardinfarct, etc.)
- Spontaan (10-20%)
Diagnose: “Budapest Criteria”
1. Continuing pain disproportionate to any inciting event
2. Must report at least one symptom in 3 or 4 following categories
- Sensory
i. Hyperesthesia and/or allodynia
- Vasomotor
i. Temperature assymetry
ii. Skin colour changes
iii. Swearing asymmetry
- Sudomotor/Oedema
i. Oedema;
ii. Sweating changes
iii. Sweating assymetrie
- Motor/trophic
i. Decreased ROM
ii. Motor dysfunction (weakness, tremor, dystonia)
iii. Trophic changes (nail, hair, skin)
3. Must display at least one sign at time of evaluation in 2 or more of these
categories:
4. There is no other diagnosis that better explains the signs and symptoms
IASP criteria hebben: Hoge senistiviteit (1.00), lage specificiteit (0.41).
Budapest criteria: iets lagere senisitiveit (0.98), maar hogere specificiteit (0.68)
“The diagnosis CRPS can be made on the basis of clinical diagnostic criteria. In
77% of presumed CRPS patients an alternative diagnosis was made. In most
cases this involved an underlying untreated trigger.”
Additionele diagnostiek
- Imaging techniques
- General blood tests
- Skin testing
- Measuring skin temperature
- Sympathetic and sudomotor function tests
- Neurophysiological assessment
- QST
Methodological shortcoming, unclear and differing patient populations,
reference tests lacking
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller MdG. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $0.00. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
76462 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now