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Correlation Between 3 Phase Bone Scintigraphy and Pressure Pain Thresholds in Patients With Complex Regional Pain Syndrome (CRPS)

Completed
Conditions
Complex Regional Pain Syndrome Type I of the Upper Limb
Unilateral Limb Pain of Other Origin
Healthy Subjects
Interventions
Procedure: Pressure Pain measurement
Registration Number
NCT01623141
Lead Sponsor
Ruhr University of Bochum
Brief Summary

The aim of the study is to investigate the correlation between increased bone metabolism in the 3 phase bone scintigraphy (TPBS) and decreased pressure pain thresholds in patients with complex regional pain syndrome (CRPS) of the upper limb and a non-CRPS-group. The investigators assume that there will be a significant correlation between the investigated values in the CRPS-group whereas the non-CRPS-group shows no significant correlation.

Detailed Description

Pressure pain of the distal hand joints is a predominant symptom of CRPS. But so far, the diagnostic value of pressure pain in the diagnosis of CRPS has not been investigated. We compared the pressure pain thresholds of the carpus, metacarpophalangeal and proximal interphalangeal joints to a region of interest-based (ROI) analysis of a TBPS in patients with CRPS and patients with limb pain of other origin (non-CRPS-group).Additionally, the PPTs were established for a healthy control group to get reference data.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
53
Inclusion Criteria

every participant:

  • aged > 18 years with written informed consent
  • adequate understanding of the german language
  • indication for a TPBS independent of the study

Patients with CRPS:

  • patients with CRPS type 1 of the upper limb diagnosed on the basis of the budapest criteria (Harden, Bruehl et al., 2010)
  • unilateral pain

Control group:

  • patients with pain of the upper limbs of other origin than CRPS who underwent a TPBS
  • unilateral pain

Healthy subjects:

  • checked by the DFNS IMI questionnaire
Exclusion Criteria
  • missing informed consent
  • inadequate understanding of the german language
  • disease duration of more than 12 months
  • other disease of the upper extremity (e.g. polyarthrosis, rheumatoid arthritis)
  • pregnancy/ lactation period

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Patients with CRPSPressure Pain measurement18 patients with unilateral CPRS of the upper limb were included to the study
Patients with limb pain of other originPressure Pain measurement17 patients with unilateral upper limb pain of other origin served as control group
Healthy subjectsPressure Pain measurement18 healthy subjects were included to establish reference data for the pressure pain thresholds
Primary Outcome Measures
NameTimeMethod
Decrease of the pressure pain thresholds of the distal hand jointshalf an hour

The pressure pain thresholds (PPT) were mesured for the carpus, metacarpophalangeal and proximal interphalangeal joints of both hands. The mean of three determined measurements of each joint was taken as the final value. Subseqently the PPT were compared to the results of the 3 phase bone scintigraphy and the reference data of the healthy subjects.

Secondary Outcome Measures
NameTimeMethod
Increased bone metabolism in the 3 phase bone scintigraphy3 hours

All Patients with CRPS and limb pain of other origin underwented a 3 phase bone scitigraphy to investigate a possible increased bone metabolism. Phase one and two were recorded within the first five minutes after injection of approximately 500-700 MBq 99mTechnetium-labeled methylene diphosphonate. The third phase was obtained two to three hours after injection.

Trial Locations

Locations (1)

Bergmannsheil, department for pain management

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Bochum, Nordrhein-Westfalen, Germany

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