Complex regional pain syndrome in pediatric sports: a case series of three young athletes
Martínez-Silvestrini, J.A.; Micheo, W.F.
Boletin de la Asociacion Medica de Puerto Rico 98(1): 31-37
2006
ISSN/ISBN: 0004-4849 PMID: 19610548 Document Number: 702374
Outpatient Sports Medicine Clinic. Three adolescent young female athletes who developed clinical findings compatible with complex regional pain syndrome (CRPS) after lower extremity trauma. Based on the clinical picture, the patients were identified and treated with physical therapy, which included desensitization techniques, stress loading, edema control, early mobilization and electrical stimulation. It was combined with pharmacotherapeutic measures such as non-steroidal anti-inflamatories, oral corticosteroids and gabapentin. One of the patients required serotonin selective reuptake inhibitors, opioid analgesics and acupuncture as an adjunctive treatment. All three patients had involvement of the lower extremities, with a degree of pain and edema exceeding the expected for the nature of their injury. They exhibited a good response to conservative treatment, with physical therapy playing a significant role on the treatment plan. One of the patients, whose diagnosis and treatment was delayed due to late referral, had a more severe presentation and protracted recovery. CRPS is a challenging disease that may affect young active and athletic patients. In this population, early clinical suspicion and aggressive treatment may lead to excellent clinical results and the avoidance of invasive procedures or long-term disability. Laboratory and imaging studies should be used to discard other conditions with clinical presentations similar to CRPS.
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