Sudeck's algodystrophy syndrome

Sudeck's algodystrophy syndrome can be found in patients during the healing period of fractures, when a patient develops a state of excessive pain, swelling and stiffness. It is also called CRPS (complex regional pain syndrome).

General characteristics[edit | edit source]

Paul Sudeck, pediatric surgeon (1866–1945)

Patogenesis is not fully clear. A certain role is played by the sympathetic nervous system. The syndrome can also be caused by infections, myocardial infarction, tumors, strokes, etc. In fractures, it most frequently occurs after Colles' fracture, ankle, foot or knee injuries.

Basic criteria[edit | edit source]

regional pain
changes in skin color
fevers, abnormal sweating, swelling

Clinical finding[edit | edit source]

The basic symptom is spontaneous pain, without any apparent cause:

allodynia – pain after a normally painless stimulus, or
hyperalgesia – pain, which is excessive in relation to the stimulus intensity.

We distinguish between 3 stages of the disease:

acute (inflammatory) stage,
- hyperemia, swelling, the affected limb is warmer than the other, the skin appears shiny,
- occurs within 2-8 weeks after the precipitating cause,
middle dystrophic stage,
- swelling subsides
- pain is relieved, but persists during movement
- shiny, cyanotic skin,
atrophic stage
- after 6-12 months,
- muscle atrophy, fibrotization of joint capsules, contractures, diffuse osteoporosis on skiagram.

The pain can be worsened by visual, auditory and psychological stimuli. The relief can be brought by seemingly strange methods:

wet compress for a wrist affliction,
if the knee joint is affected, it is pathognomonic to wear short pants and thick socks even in the cold, or pants with cut-out windows on the knees (rubbing the knees against clothing can hurt immensely).

Without treatment, it can persist at any stage for months or even years.

Treatment[edit | edit source]

Relief is brought by sympathetic blockade
Exercise/Physiotherapy ^[1]
Bisphosphonates, NSAIDS, sympatolytics (dihydroergotoxin), anxiolytics (diazepam), calcitonin

Links[edit | edit source]

External links[edit | edit source]

https://www.akutne.cz/algorithm/cs/241--/

Source[edit | edit source]

BENEŠ, Jiří. Studijní materiály [online]. [cit. 8. 1. 2010]. <http://jirben.wz.cz>.

References[edit | edit source]

↑ COSSINS, L, R W OKELL a H CAMERON, et al. Treatment of complex regional pain syndrome in adults: a systematic review of randomized controlled trials published from June 2000 to February 2012. Eur J Pain [online]. 2013, vol. 17, no. 2, s. 158-73, dostupné také z <https://www.ncbi.nlm.nih.gov/pubmed/23042687>. ISSN 1090-3801 (print), 1532-2149

[1] COSSINS, L, R W OKELL a H CAMERON, et al. Treatment of complex regional pain syndrome in adults: a systematic review of randomized controlled trials published from June 2000 to February 2012. Eur J Pain [online]. 2013, vol. 17, no. 2, s. 158-73, dostupné také z <https://www.ncbi.nlm.nih.gov/pubmed/23042687>. ISSN 1090-3801 (print), 1532-2149

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