Christoph A Agten1, Adrian Kobe2, Isabelle Barnaure3, Julien Galley3, Christian W Pfirrmann3, Florian Brunner4. 1. University Hospital Balgrist, Radiology, Forchstrasse 340, 8008 Zurich, Switzerland; University of Zurich, Faculty of Medicine, Pestalozzistrasse 3, 8091 Zurich Switzerland. Electronic address: Christoph.agten@balgrist.ch. 2. University Hospital Zurich, Radiology, Rämistrasse 100, 8091 Zurich, Switzerland; University of Zurich, Faculty of Medicine, Pestalozzistrasse 3, 8091 Zurich Switzerland. 3. University Hospital Balgrist, Radiology, Forchstrasse 340, 8008 Zurich, Switzerland; University of Zurich, Faculty of Medicine, Pestalozzistrasse 3, 8091 Zurich Switzerland. 4. University Hospital Balgrist, Rheumatology, Forchstrasse 340, 8008 Zurich, Switzerland; University of Zurich, Faculty of Medicine, Pestalozzistrasse 3, 8091 Zurich Switzerland.
Abstract
PURPOSE: To evaluate the diagnostic potential of MRI in patients with suspected CRPS (complex regional pain syndrome). METHOD: A retrospective health-record search was conducted for patients with suspected CRPS (foot). Fifty patients with initially suspected CRPS were included (37 females (51 ± 13 years) and 13 males (44 ± 15 years)). All patients underwent MRI. Two radiologists assessed skin, bone, and soft tissue parameters on MRI. The final diagnosis was CRPS (Gold standard: Budapest criteria) or non-CRPS. MRI parameters were compared between CRPS patients and non-CRPS patients. RESULTS: CRPS was diagnosed in 22/50(44 %) patients. Skin thickness (1.9 ± 0.5 mm vs. 1.7 ± 0.3 mm, p = 0.399), enhancement, and subcutaneous edema showed no differences between CRPS and non-CRPS patients. Bone marrow edema presence and pattern were not different between groups. Up to 50 % of CRPS patients showed no bone marrow edema. Subcortical enhancement and periosteal enhancement were not different between groups. For reader 1, muscle edema score was higher in the non-CRPS group compared to the CRPS group (0.1 ± 0.2 vs. 0.6 ± 1.0, p = 0.008), but not different for reader 2 (0.1 ± 0.5 vs. 0.2 ± 0.8, p = 0.819). Perfusion pattern was more extensive in non-CRPS patients for reader 1 (p = 0.048), but not for reader 2 (p = 0.157). Joint effusions showed no difference between groups. CONCLUSIONS: MRI cannot distinguish between CRPS and non-CRPS patients. The role of MR imaging in patients with suspected CRPS is to exclude alternative diagnoses that would better explain patients' symptoms.
PURPOSE: To evaluate the diagnostic potential of MRI in patients with suspected CRPS (complex regional pain syndrome). METHOD: A retrospective health-record search was conducted for patients with suspected CRPS (foot). Fifty patients with initially suspected CRPS were included (37 females (51 ± 13 years) and 13 males (44 ± 15 years)). All patients underwent MRI. Two radiologists assessed skin, bone, and soft tissue parameters on MRI. The final diagnosis was CRPS (Gold standard: Budapest criteria) or non-CRPS. MRI parameters were compared between CRPS patients and non-CRPS patients. RESULTS: CRPS was diagnosed in 22/50(44 %) patients. Skin thickness (1.9 ± 0.5 mm vs. 1.7 ± 0.3 mm, p = 0.399), enhancement, and subcutaneous edema showed no differences between CRPS and non-CRPS patients. Bone marrow edema presence and pattern were not different between groups. Up to 50 % of CRPS patients showed no bone marrow edema. Subcortical enhancement and periosteal enhancement were not different between groups. For reader 1, muscle edema score was higher in the non-CRPS group compared to the CRPS group (0.1 ± 0.2 vs. 0.6 ± 1.0, p = 0.008), but not different for reader 2 (0.1 ± 0.5 vs. 0.2 ± 0.8, p = 0.819). Perfusion pattern was more extensive in non-CRPS patients for reader 1 (p = 0.048), but not for reader 2 (p = 0.157). Joint effusions showed no difference between groups. CONCLUSIONS: MRI cannot distinguish between CRPS and non-CRPS patients. The role of MR imaging in patients with suspected CRPS is to exclude alternative diagnoses that would better explain patients' symptoms.
Authors: Diana Andronic; Octavian Andronic; Astrid Juengel; Martin C Berli; Oliver Distler; Florian Brunner Journal: Rheumatol Int Date: 2022-01-08 Impact factor: 2.631
Authors: Alireza K Nazemi; John Grossi; Felix B Tavernier; Brendan F Boyce; David E Komatsu; Fazel A Khan Journal: J Am Acad Orthop Surg Glob Res Rev Date: 2022-07-06