Regional Pain - Signs and symptoms

International Association for the Study of Pain diagnostic criteria for listing regional pain syndrome:Presence of an initiator-factor or a cause of immobilization-Pain continues, allodinia (perception of pain stimulus printrun nondureros) or hyperalgesia disproportionate to the incident triggering-Evidence of edema, changes in blood flow, abnormal activity in the pain sudomotorie-Diagnosis is excluded by the existence of conditions which cause pain and dysfunction.Other signs and symptoms of patients accused include:-Pain, swelling, stiffness and discoloration-Intense pain and burning, disproportionate to the injury, which affects the entire extremity-Hiperpatia refers to pain that persists after the stimulus was removed-Allodinia pain refers to light touching-Movement aggravates painCold-description exacerbations-Edema is one of the first signs appearedErythematosus-discoloration varies from intensely cyanotic, purple, pale or gray.
Lankford side Features include:-Demineralization and osteoporosis as evidence late decsriseSudomotorii-changes ranging from hyperhidrosis to dryness-Temperature difference between affected and unaffected extremity is markedVasomotor instability, manifested by poor capillary refill-Erythema may be a sign of increased capillary refilling-Can get shiny skin, trophic changes occur in late stages with lower subcutaneous tissueDamage to the hand-in lumps and thickening of the palmar fascia.
Impaired motor function:Although regional pain syndrome does not involve motor dysfunction in diagnostic criteria that is frequently present.Abnormal motor symptoms reported include:-Unable to initiate movement-Weakness, tremor-Muscle spasms, dystonia affected limb.Altered sensory function: although regional pain syndrome does not involve sensory impairment are described hypoesthesia, hyperesthesia and allodinia.Affecting Psychological condition is commonly seen in patients with the syndrome: anxiety, depression.
Describe the three stages of the disease. Progress is variable condition.Stage I:The pain is more severe than expected from injury, the burning quality. May be increased to move member, contact or emotional stress. The affected area becomes edematous, hyperthermia or hypothermia with increased hair and nail growth. X-rays show changes in the bones. Stage duration is 3 months after onset of symptoms. Some patients remain in stage I for ulti years. They may not ever progress. Physical elements in this stage may be minimal.
Stage II or established regional pain syndrome:Tissue edema is endured, the skin is cold and hiperhidrotica with livedo reticularis or cyanosis, lost hair and nails become rigid, and sfarimicioase. Dry hands is prominent and the skin and subcutaneous tissue atrophy detectable. Pain remains the dominant element. It is usually constant and increased by any stimulation of the affected area. Stiffness develops at this point.Radiograph showed diffuse osteoporosis. Bone scan is positive.Duration is 3-12 months after onset.
Stage III or late:Pain extends proximally, although lower in intensity remains predominant. Exacerbations occur spontaneously. Irreversible alteration of tissue occurs. The skin is thin and shiny. Edema is absent. Contractions occur. Radiograph shows marked demneralizare.
Complications include regional pain syndrome:Chronic edema, occasionally with chronic lymphedemaUlcers, chronic infections and recurrent treatment-resistantGray-brown pigmentation, scaly skinHematoma, recurrent spontaneous-Dystonia, tremor and other movement disorders-Hipocratismul fingers and watch glass nailsFor depression and other psychiatric disorders.