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
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

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

Clinical finding
The basic symptom is spontaneous pain, without any apparent cause: We distinguish between 3 stages of the disease: The  pain can be worsened by visual, auditory and psychological stimuli. The relief can be brought by seemingly strange methods:
 * allodynia – pain after a normally painless stimulus, or
 * hyperalgesia – pain, which is excessive in relation to the stimulus intensity.
 * 1) acute (inflammatory) stage,
 * 2) * hyperemia, swelling,the affected limb is warmer than the other, the skin appears shiny,
 * 3) * occurs within 2-8 weeks after the precipitating cause,
 * 4) middle dystrophic stage,
 * 5) * swelling subsides
 * 6) * pain is relieved, but persists during movement
 * 7) * shiny, cyanotic skin,
 * 8) atrophic stage
 * 9) * after 6-12 months,
 * 10) * muscle atrophy, fibrotization of joint capsules, contractures, diffuse osteoporosis on skiagram.
 * 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).

Treatment

 * Relief is brought by sympathetic blockade
 * Exercise/Physiotherapy
 * Bisphosphonates, NSAIDS, sympatolytics (dihydroergotoxin), anxiolytics (diazepam), calcitonin

Related articles

 * Volkmann ischemic contracture
 * Compartment syndrom