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KMID : 0361420150390010116
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Journal of Korean Academy of Rehabilitation Medicine
2015 Volume.39 No. 1 p.116 ~ p.121
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Predictive Value of Sympathetic Skin Response in Diagnosing Complex Regional Pain Syndrome: A Case-Control Study
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:Kim Hyun-Jung
:Yang Hea-Eun/:Kim Dae-Hyun/:Park Yoon-Ghil
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Abstract
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Objective: To investigate the predictive value of the sympathetic skin response (SSR) in diagnosing complex regional pain syndrome (CRPS) by comparing three diagnostic modalities?SSR, three-phasic bone scans (TPBS), and thermography.
Methods: Thirteen patients with severe limb pain were recruited. Among them, 6 were diagnosed with CRPS according to the proposed revised CRPS clinical diagnostic criteria described by the International Association for the Study of Pain. SSR was measured in either the hands or feet bilaterally and was considered abnormal when the latency was prolonged. A positive TPBS finding was defined as diffuse increased tracer uptake on the delayed image. Thermographic findings were considered positive if a temperature asymmetry greater than 1.00oC was detected between the extremities.
Results: Five of 6 CRPS patients showed prolonged latency on SSR (83% sensitivity). TPBS was positive in the 5 CRPS patients who underwent TPBS (100% sensitivity). Thermography was positive in 4 of 5 CRPS patients who underwent the procedure (80% sensitivity). The remaining 7 non-CRPS patients differed on examination. SSR latencies within normal limit were noted in 4 of 7 non-CRPS patients (57% specificity). Results were negative in 4 of 5 non-CRPS patients who underwent TPBS (80% specificity), and negative in 3 of 5 non-CRPS patients who underwent thermography (60% specificity).
Conclusion: SSR may be helpful in detecting CRPS.
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KEYWORD
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Complex regional pain syndromes, Galvanic skin response, Radionuclide imaging, Thermography
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