Complex regionaal pijnsyndroom type 1

Complex regional pain syndrome type 1 (CRPS-1) is a difficult diagnosis since the aetiology is unclear and there is no specific diagnostic test or gold standard. The diagnostic criteria lists recommended by the Dutch guideline are sensitive, but the specificity of most is poor. We present two patients who had CRPS-1 according to the Bruehl-criteria. In one patient, however, the symptoms were caused by an exostosis and disappeared after removal of the exostosis. In the other, the diagnosis was made too early and the symptoms disappeared after physiotherapy. According to our data, in 77% of the patients suspected of having CRPS, another underlying cause for pain and dysfunction could be found. CRPS-1 should be diagnosed with caution, since there are other somatic disorders that may cause a CRPS-like autonomic disorder of an extremity. It is our experience that it is advantageous to examine patients with a possible diagnosis of CRPS in a multidisciplinary outpatient setting comprising various medical experts.