RSD CRPS RSD Reflex Sympathetic Dystrophy 1 RSD RSD 100 1864 1 S. W. Mitchell 1867 causalgia kausos 153
algos 1900 P. H. M. Sudeck Sudeck s atrophy Sudeck post-traumatic pain syndrome sympathetic dystrophy shoulder-hand syndrome 1947 J. A. Evans RSD 2 1953 Bonica RSD major minor 1977 Lankford 3 major causalgia minor causalgia 1 Gunshot Wounds and Other Injuries of Nerves J. B. Lippincott 1864 British Library Mitchell SW, Morehouse GR Gunshot Wounds, And Other Injuries Of Nerves 1864 Kessinger Publishing 2008 Reprint 2 Evans JA REFLEX SYMPATHETIC DYSTROPHY; REPORT ON 57 CASES Annals Internal Medicine 26 : 417-426 1947. 3 Lankford LL : Reflex Sympathetic Dystrophy Surgery of the Musculoskeletal System 2nd ed. Churchill Livingstone. 1265-1296 1272 1990. 154
major traumatic dystrophy RSD minor traumatic dystrophy RSD shoulder-hand syndrome Lankford 3 4 Lankford 1 3 1 1 1 3 2 3 9 2 4 id. 1271 155
2 1 2 2 3 3 9 2 3 3 3 Lankford RSD RSD sympathetically maintaind pain SMP 5 RSD 5 SMP SIP 45 1311 1313 2002 156
RSD sympathetically independent pain SIP sympathetic RSD International Association of the Study of Pain IASP 1986 causalgia RSD 1994 RSD RSD causalgia SMP SIP CRPS Complex Regional Pain Syndrome 6 RSD dystrophy CRPS CRPS Type RSD Type causalgia 7 RSD CRPS CRPS RSD RSD RSD 8 RSD 6 Merskey H, Bogduk N : Complex Regional Pain Syndromes CRPS Classification of Chronic Pain 2nd ed. IASP Press. 40-43 40 41 1994. 7 id. 42 8 RSD CRPS ADL 39 4 359 359 2005 157
RSD 9 Pain and tenderness in the distal extremity Signs and/or symptoms of vasomotor instability Swelling in the extremity often with periarticular prominence Dystrophic skin changes usually present Pain and tenderness AND Vasomotor instability OR Swelling Dystrophic skin changes often present 9 Kozin F et al The Reflex Sympathetic Dystrophy Syndrome RSDS The American Journal of Medicine 70 : 23-30 29 1981. 158
Vasomotor instability OR/AND Swelling No pain but mild-moderate tenderness may be present Dystrophic skin changes occasionally present Unexplained pain and tenderness in an extremity 10 Allodynia or hyperpathia 11 Burning pain Edema Color or hair growth changes Sweating changes Temperature changes 10 Gibbons JJ, Wilson PR RSD score : Criteria for the Diagnosis of Reflex Sympathetic Dystrophy and Causalgia The Clinical Journal of Pain 8 : 260-263 261 1992. 11 Allodynia Hyperpathia 45 1319 1321 2002 159
Radiographic changes demineralization X Quantative measurement of vasomotor/sudomotor disturbance / Bone scan consistent with RSD RSD Response to sympathetic block 1 0.5 0 3 RSD not to have RSD 3 4.5 RSD possible RSD 5 RSD probable RSD 12 The presence of an initiating noxious event, or a cause of immobilization Continuing pain allodynia, or hyperalgesia with which the pain is disproportionate to any inciting event Evidence at some time of edema, changes in skin blood flow, or abnormal sudomotor activity in the region of the pain 12 Merskey H, Bogduk N : Complex Regional Pain Syndromes CRPS Classification of Chronic Pain 2nd ed. IASP Press. 40-43 42 1994. 22 47 49 2003 45 1313 RSD CRPS 160
This diagnosis is excluded by the existence of conditions that would otherwise account for the degree of pain and dysfunction Note Criteria 2-4 must be satisfied The presence of continuing pain, allodynia, or hyperalgesia after a nerve injury, not necessarily limited to the distribution of the injured nerve Evidence at some time of edema, changes in skin blood flow, or abnormal sudomotor activity in the region of the pain This diagnosis is excluded by the existence of conditions that would otherwise account for the degree of pain and dysfunction Note All three criteria must be satisfied 13 symptom 4 3 1 sign 4 2 1 13 http://www.shiga-med.ac.jp/ ~ koyama/analgesia/pain-crps.html 161
symptom 4 1 sign 4 2 1 Positive sensory abnormalities spontaneous pain hyperalgesia mechanical thermal deep somatic Vasscular abnormalities vasodilatation vasoconstriction skin temperature asymmetries skin color changes Edema sweating abnormalities swelling hyperhidrosis hypohidrosis Motor or tropic changes motor weakness tremor dystonia coordination deficits nail or hair changes skin atrophy joint stiffness soft tissue changes 162
2005 CRPS type type RSD RSD 50 9 30 565 7 3 9 7 2 12 12 14 2003 15 8 8 0808002 RSD 3 7 3 9 7 2 12 12 15 14 10 2000 144 163
Kozin Gibbons IASP 1994 2005 RSD RSD RSD 16 RSD IASP 2005 RSD 1 2 15 13 2004 157 158 16 13 PTSD RSD 26 3 21 2001 17 RSD 2006 18 53 71 18 2008 282 293 164
RSD RSD 46 1 RSD RSD 5 6 67 60 2 RSD 10 14 31 1 2 14 RSD 5 67 64 40 2 RSD 12 12 10 14 17 X 41 Y1 X Y1 165
X Y X Y X 1 X 11 RSD 2 RSD 1994 IASP Type Veldman Gibbons Harden X RSD RSD 7 4 56 67 26 50 RSD 28 RSD RSD 13 10 5 1421 1 13 3 29 RSD 17 2005 1 166
2005 IASP U X 42 X X X 12 13 17 4 3 1 2 1 RSD 3 RSD RSD X RSD 10 10 27 167
X 52 6 3 RSD RSD RSD RSD Gibbons RSD 9 10 35 20 3 18 1 2005 IASP 168
20 5 21 1 IASP Gibbons Gibbons 18 9 28 RSD IASP RSD RSD 20 3 18 20 5 21 169
RSD X 30 Y X RSD 3 Y X RSD X RSD RSD RSD 4 X RSD X RSD 7 56 RSD 2 170
2 X RSD X visual analog scale RSD RSD 7 3 9 7 2 12 12 RSD 171
RSD RSD RSD RSD 7 RSD 30 55 18 RSD Lankford 19 RSD 18 45 1320 19 Lankford LL : Reflex sympathetic dystrophy Surgery of the Musculoskeletal System 2nd ed. Churchill Livingstone. 1265-1296 1277 1990. 26 47 2001 Lankford 49 RSD86 16 18 6 22 51 172
20 14 8 21 35 4 1125 Lankford RSD RSD X 48 1 RSD 12 12 10 14 X X RSD 16 7 28 37 4 1020 X 26 27 RSD 5 2 67 79 5 RSD X 20 45 1321 173
1 RSD RSD X X X RSD 18 9 28 MRI X X RSD 2 3 4 50 20 5 21 RSD RSD RSD 20 6 13 RSD X Y 174
RSD Y RSD RSD RSD ICD 10 DSM PTSD 21 RSD 21 2003 225 175
176