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Clinical Features of Pediatric Complex Regional Pain Syndrome

A 5-Year Retrospective Chart Review

Mesaroli, Giulia MScPT*,†; Ruskin, Danielle PhD; Campbell, Fiona MD§; Kronenberg, Sefi MD, PhD∥,¶; Klein, Sara MScPT*; Hundert, Amos BSc#; Stinson, Jennifer PhD#,**

doi: 10.1097/AJP.0000000000000759
Original Articles
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Objectives: Complex regional pain syndrome (CRPS) is a painful condition of a limb characterized by a constellation of symptoms. Little is known about the clinical features of pediatric CRPS, with fewer than a dozen studies published to date. The aim of this study was to explore the clinical course of pediatric CRPS, with emphasis on clinical features and disease outcomes. A secondary aim was to discern differences in clinical features of pediatric CRPS with and without related movement disorders, and between children who had a favorable and unfavorable outcome.

Materials and Methods: We carried out a retrospective chart review of children with CRPS who presented to a pediatric Chronic Pain Clinic in Canada over a 5-year period (2012 to 2016).

Results: The study identified 59 children with CRPS (mean age: 12.7±2.5; 74.6% female; 72.9% lower extremity). In total, 87% (n=48) of children experienced complete resolution or significant improvement of CRPS, with a relapse rate of 15%. Overall, 25% (n=15) had a CRPS-related movement disorder. There were no differences in the clinical features of pediatric CRPS with or without related movement disorders. Children who experienced a favorable outcome had a significantly shorter symptom duration at the initial visit in comparison with children who experienced an unfavorable outcome.

Discussion: In this cohort, pediatric CRPS was most common in girls around the age of 12, usually in the lower extremity, and most experienced a favorable outcome. Further research is needed to better understand the prognosis and relapse rate of pediatric CRPS.

Departments of *Rehabilitation

Psychology

Psychiatry

#Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children

§Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, University of Toronto

Departments of Physical Therapy

Psychiatry

**Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada

The authors declare no conflict of interest.

Reprints: Giulia Mesaroli, MScPT, Department of Rehabilitation, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, Canada M5G 1×8 (e-mail: giulia.mesaroli@sickkids.ca).

Received April 12, 2019

Received in revised form July 11, 2019

Accepted August 19, 2019

Online date: September 4, 2019

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