A New Clinical Severity Scoring System for Reflex Sympathetic Dystrophy of the Upper Limb

Abstract

A scoring system for the clinical severity of reflex sympathetic dystrophy (RSD) is proposed. The following signs and symptoms were considered to be significant: pain, reduction of finger flexion, swelling, temperature changes, discolouration, sensory disturbances, shoulder pain and loss of movement, increased sweating, and hair/nail growth changes. One point was assigned for strong expression of most of these features, half a point for moderate expression and no point if the feature was absent. A total score of 4 points was assumed, empirically, to indicate a mild degree of RSD, and the maximum score of 10 to indicate the most severe form of RSD. One hundred and forty-six patients with RSD of the hand were classified according to this system. Seventy-four patients (51%) had a score of 4-6, 51 patients (35%) a score of 6.5-8, and 21 patients (14%) a score of 8.5-10. Use of this system will allow more precise analysis of RSD patients and facilitate comparisons between studies.

Treatment of Early Complex Regional Pain Syndrome Type 1 by A Combination of Mannitol and Dexamethasone

“…A total of 75 patients, 68 women (91%) and seven men (9%), with a mean age of 58 (range 38-82) years were diagnosed as having CRPS Type 1, based on our own diagnostic algorithm (CRPS score) (Table 1) (Zyluk, 2003). All the patients included in the study experienced severe pain at rest, or on the slightest movement, and had a CRPS score greater than or equal to four points.…”

“…Hair and nail growth changes and shoulder pain and loss of movement were only assigned half a point when present because they are less important to the diagnosis and to the morbidity of the condition. A total score of four points was assumed, empirically, to indicate a mild degree of CRPS Type 1 and a maximum score of 10 to indicate a severe degree of the condition (Zyluk, 2003). The CRPS score includes all the above parameters, except grip strength and, therefore, we considered it a primary outcome measure in our study.…”

Complex Regional Pain Syndrome Type 1 after Fractures of the Distal Radius: A Prospective Study of the Role of Psychological Factors

“…We did not consider other tests, such as radiography and bone scintigraphy to be helpful in making the diagnosis (Zyluk, 1999). We used a scoring system for assessment of the presence and clinical severity of CRPS Type 1 described by Zyluk (2003) ( Table 1). A total score of 4, or more, indicates a mild degree of CRPS Type 1 and the maximum score of 10 indicates the most severe form of CRPS Type 1.…”

Role of Biphosphonates and Lymphatic Drainage Type Leduc in the Complex Regional Pain Syndrome (Shoulder–Hand Syndrome)

“…In particular, VAS was 8/10 before combined treatment; at 1 month follow‐up after the beginning of combined treatment, pain level was: VAS = 6/10; at 2 months follow‐up, pain level was: VAS = 3/10. Furthermore, a scoring system for the clinical severity of CRPS‐SHS was performed [15]. With this scale, patients with a total score of 4 or more were considered to have CRPS‐SHS.…”