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The Usefulness of Three-phase Bone Scan and Thermography for Making the Diagnosis of CRPS-I  

Park, Sang Hyun (Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Bundang Hospital)
Lee, Pyung Bok (Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Bundang Hospital)
Lim, Yun Hee (Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Bundang Hospital)
Lee, Seung Yoon (Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Bundang Hospital)
Choi, In Yong (Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Bundang Hospital)
Lee, Sang Jin (Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Bundang Hospital)
Oh, Yong Seok (Department of Anesthesiology and Pain Medicine, Seoul National University College of Medicine, Bundang Hospital)
Publication Information
The Korean Journal of Pain / v.19, no.1, 2006 , pp. 81-86 More about this Journal
Abstract
Background: Complex regional pain syndrome (CRPS) is a painful and disabling disease, yet the diagnosis of this can be difficult to confirm by purely objective measures. Therefore, we performed three-phasic bone scans and thermography as a work up in order to determine their predictive value and usefulness for making the diagnosis of CRPS. Methods: 44 patients who had been diagnosed with CRPS type-1, according to the modified criteria, were evaluated. All the patients were examined by performing a three-phasic bone scan and thermography as part of a work-up for diagnostic confirmation. The diffuse increased tracer uptake in the delayed image (phase III) was estimated by the positive findings. The findings were considered positive for CRPS if the thermographic findings showed temperature asymmetries between the affected and non- affected extremities of more than $1.00^{\circ}C$ Results: A review of the three-phasic bone scan for 44 patients indicated that 16 patients (36.4%) had diffusely positive scans, and thermographic abnormalities were noted in 35 of 44 patients (79.5%). Conclusions: The use of thermography in clinical settings can play an important role in the diagnosis of CRPS. However, a three-phasic bone scan alone cannot provide a completely accurate diagnosis, so it is imperative that the three-phasic bone scan data be integrated with the clinical evaluation and the other relevant tests.
Keywords
CRPS; thermography; three-phasic bone scan;
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