Pediatric Complex Regional Pain Syndrome

Low, A., Ward, K. & Wines, A.

Pediatric CRPs is a fairly new diagnostic entity and there is some debate as to the best course of treatment. This study looks at 20 children diagnosed with CRPS over a 4 year period, presenting their characteristics, clinical courses and treatment outcomes. They discovered that pediatric CRPS occurs mainly in girls (90%) and affects mainly the lower limbs. It seemed to occur in late childhood/adolescence and was frequently initiated by minor trauma (80%).

The authors also note in many cases there was a lengthy time to diagnosis, delaying the institution of treatment, which consisted of both intensive physiotherapy and psychotherapy. Many of the children required adjuvant medications to participate in therapy, 70% of all cases. 40% of the children required an inpatient hospital stay to achieve complete resolution of symptoms however a large number had resolved symptoms following this treatment regime. 20% has a relapse episode.

The authors believe that pediatric CRPS is under-acknowledged by clinicians resulting in lengthy delays however it responds favourably to non invasive treatment. The lengthy time period to achieve complete resolution of symptoms in some children and the high number of those suffering relapsing episodes supports the need for further research in this area. 

Journal of Pediatric Orthopedics 2007. 27(5):562-572

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