Complex regional pain syndrome of the knee – a case report

Abstract

Background: Persistent unexplained pain around the knee can be a perplexing problem. Reports of complex regional pain syndrome involving primarily knee have been published, yet complex regional pain syndrome of the knee is infrequently included in differential diagnosis of pain out of proportion. Case presentation: A 54 year old female presented to the physiotherapy outpatient department with complains of severe anterior knee pain and stiffness, persisting for more than 2 months post arthroscopic medial plical excision. The patient met the criteria for establishing a probable diagnosis of complex regional pain syndrome (CRPS) knee. Pressure algometre, goniometric measurements and knee outcome survey activities of daily living scale were used to document any changes. This patient was managed for a period of four sessions using graded desensitization therapy, TENS and mobilisation with feedback. Patient showed marked improvement in range of movement (ROM), hypersensitivity, pain and function. Conclusion: Meticulous examination, early diagnosis and prompt treatment resulted in a quick improvement in the patient's condition.

Dorsal Column Stimulation vs. Dorsal Root Ganglion Stimulation for Complex Regional Pain Syndrome Confined to the Knee: Patients’ Preference Following the Trial Period

“…Complex regional pain syndrome (CRPS), formerly known as reflex sympathetic dystrophy (RSD) or algodystrophy, is a collection of locally appearing painful conditions following a trauma. Although CRPS mainly occurs in the feet or hands, other locations are also reported . CRPS exceeds in both intensity and duration the expected course of the original trauma.…”

Complex regional pain syndrome type II caused by iatrogenic lateral dorsal cutaneous nerve injury

“…Other typical features include hyperesthesia, vasomotor symptoms, hyperhydrosis, and trophic changes. [ 11 ] The Budapest criteria are the accepted diagnostic criteria for CRPS (Table 2 ). [ 12 ] According to the criteria, CRPS diagnosis requires the presence of at least one symptom in three or more of the following four categories: sensory, vasomotor, sudomotor/edema, and motor/trophic.…”

“…Furthermore, active treatment in the early stage of CRPS improves its prognosis. [ 10 , 11 ] This case report is the first to describe the experience of using a diagnostic approach and treatment in a patient with iatrogenic LDCN injury who progressed to CRPS.…”

Response to the Letter to the Editor

“…We agree with the authors of the letter to the editor that “CRPS confined to the knee is infrequently encountered in differential diagnosis of knee pain.” We hope that our previous and current work, the letter to the editor, and our answers will change this and be of help for those patients with a serious, invalidating problem that is denied too often.…”