Correlation Between 3 Phase Bone Scintigraphy and Pressure Pain Thresholds in Patients With Complex Regional Pain Syndrome (CRPS)

Overview

The aim of the study is to investigate the correlation between increased bone metabolism in the 3 phase bone scintigraphy (TPBS) and decreased pressure pain thresholds in patients with complex regional pain syndrome (CRPS) of the upper limb and a non-CRPS-group. The investigators assume that there will be a significant correlation between the investigated values in the CRPS-group whereas the non-CRPS-group shows no significant correlation.

Full Title of Study: “Correlation Between 3 Phase Bone Scintigraphy and Pressure Pain Thresholds in Patients With CRPS”

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Prospective
  • Study Primary Completion Date: October 2011

Detailed Description

Pressure pain of the distal hand joints is a predominant symptom of CRPS. But so far, the diagnostic value of pressure pain in the diagnosis of CRPS has not been investigated. We compared the pressure pain thresholds of the carpus, metacarpophalangeal and proximal interphalangeal joints to a region of interest-based (ROI) analysis of a TBPS in patients with CRPS and patients with limb pain of other origin (non-CRPS-group).Additionally, the PPTs were established for a healthy control group to get reference data.

Interventions

  • Procedure: Pressure Pain measurement
    • The pressure pain thresholds were established using a manual pressure algometer. The investigated joints were the carpus, the metacarpophalangeal and the proximal interphalangeal joints

Arms, Groups and Cohorts

  • Patients with CRPS
    • 18 patients with unilateral CPRS of the upper limb were included to the study
  • Patients with limb pain of other origin
    • 17 patients with unilateral upper limb pain of other origin served as control group
  • Healthy subjects
    • 18 healthy subjects were included to establish reference data for the pressure pain thresholds

Clinical Trial Outcome Measures

Primary Measures

  • Decrease of the pressure pain thresholds of the distal hand joints
    • Time Frame: half an hour
    • The pressure pain thresholds (PPT) were mesured for the carpus, metacarpophalangeal and proximal interphalangeal joints of both hands. The mean of three determined measurements of each joint was taken as the final value. Subseqently the PPT were compared to the results of the 3 phase bone scintigraphy and the reference data of the healthy subjects.

Secondary Measures

  • Increased bone metabolism in the 3 phase bone scintigraphy
    • Time Frame: 3 hours
    • All Patients with CRPS and limb pain of other origin underwented a 3 phase bone scitigraphy to investigate a possible increased bone metabolism. Phase one and two were recorded within the first five minutes after injection of approximately 500-700 MBq 99mTechnetium-labeled methylene diphosphonate. The third phase was obtained two to three hours after injection.

Participating in This Clinical Trial

Inclusion Criteria

every participant:

  • aged > 18 years with written informed consent
  • adequate understanding of the german language
  • indication for a TPBS independent of the study

Patients with CRPS:

  • patients with CRPS type 1 of the upper limb diagnosed on the basis of the budapest criteria (Harden, Bruehl et al., 2010)
  • unilateral pain

Control group:

  • patients with pain of the upper limbs of other origin than CRPS who underwent a TPBS
  • unilateral pain

Healthy subjects:

  • checked by the DFNS IMI questionnaire

Exclusion Criteria

  • missing informed consent
  • inadequate understanding of the german language
  • disease duration of more than 12 months
  • other disease of the upper extremity (e.g. polyarthrosis, rheumatoid arthritis)
  • pregnancy/ lactation period

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • Ruhr University of Bochum
  • Provider of Information About this Clinical Study
    • Principal Investigator: Christoph Maier, Prof. Dr. med. (Head of the pain clinic of the Bergmannsheil University Hospital) – Ruhr University of Bochum
  • Overall Official(s)
    • Christoph Maier, Prof. Dr., Study Director, Head of the pain clinic of the Bergmannsheil University Hospital

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