Budapest clinical criteria for the diagnosis of Complex Regional Pain Syndrome

Budapest clinical criteria for the diagnosis of Complex Regional Pain Syndrome (CRPS)?

To better discriminate CRPS and non-CRPS neuropathic pain, the diagnosis of CRPS is made when the following criteria are met:

  • • Continuing pain that is disproportionate to any inciting event
  • • At least one symptom reported in at least three of the four following categories:
    • Sensory: hyperesthesia or allodynia
    • Vasomotor: asymmetry of temperature and/or skin color changes
    • Sudomotor/edema: edema, sweating changes, or sweating asymmetry
    • Motor/trophic: decreased range of motion, motor dysfunction (tremor, weakness, dystonia), and/or trophic changes (hair, nail, skin)
  • • At least one sign at the time of evaluation in at least two of the following categories:
    • Sensory: evidence of hyperalgesia (to pinprick) and allodynia (to light touch, temperature sensation, deep somatic pressure, or joint movement)
    • Vasomotor: asymmetry of temperature (>1°C) and/or skin color changes
    • Sudomotor/edema: evidence of edema, sweating changes, or sweating asymmetry
    • Motor/trophic: evidence of decreased range of motion, motor dysfunction (tremor, weakness, dystonia), or trophic changes (hair, nail, skin)
  • • No other diagnosis better explaining the signs and symptoms.

Note: The above criteria have a sensitivity of 82% and specificity of 68% for the diagnosis of CRPS. If a patient meets one symptom from all four symptom categories and one sign from two of the four sign categories, the sensitivity is 70% and specificity is 94%.

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