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.
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).
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.
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
#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
**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: firstname.lastname@example.org).
Received April 12, 2019
Received in revised form July 11, 2019
Accepted August 19, 2019
Online date: September 4, 2019