Retrospective analysis of pediatric patients with CRPS

Abstract Aims The aim of the study was to describe the clinical features and clinical pathway of pediatric CRPS patients in HUH Children’s Hospital. Methods This retrospective study included patients admitted to the pediatric pain clinic for CRPS during six years 2008-2013. Data on time from the first symptoms to diagnosis, first appointment at the pain clinic, and symptom resolution, as well as demographic and clinical symptoms were extracted from patient records. Results Forty patients were clinically diagnosed with CRPS during the time period without using the Budapest Criteria. 75% of the patients were female, median age was 12, and in 90% of the cases the CRPS was localized in the lower extremity. The median time from first symptoms to the CRPS diagnosis was 8.5 weeks (range 0-47), to first appointment with the pain physician 10 weeks (range 2-47), and to symptom resolution 35 weeks (range 10-131). Eleven out of forty patients (27.5%) were not symptom-free at the end of the treatment period. Most common clinical finding was allodynia or hyperalgesia of the afflicted area (70%). Conclusions Compared to an earlier study performed in our hospital (retrospective study of seven years, n = 18), the number of patients has more than doubled, maybe due to better awareness of the syndrome. Our findings about demographics and localization of CRPS are in agreement with previous literature. Time to reaching diagnosis, the small number of consultations and radiographs show that CRPS is well known among pediatric orthopedic surgeons. Many Budapest criteria that are now considered important diagnostic findings were not highly prevalent in our patients (e.g. prior trauma, color changes of skin), although patient records were not always clear about the findings leading to diagnosis. The Budapest criteria should be used to standardize the diagnosis also in our pediatric patients.